go back

South Dakota rates for HCPCS L1860

Knee orthosis (KO), modification of supracondylar prosthetic socket, custom fabricated (SK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,043.94 / $1,043.94 / $1,043.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$826.39 / $964.91 / $1,043.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$755.39 / $755.39 / $1,689.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,643.57 / $1,741.88 / $2,177.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,049.66 / $1,437.53 / $6,411.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.61 / $770.57 / $1,597.18
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,404.88 / $1,689.60 / $2,319.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,383.79 / $1,713.39 / $3,228.81
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,008.38 / $1,180.56 / $1,403.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.22 / $766.30 / $1,288.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,505.28 / $1,505.28 / $1,505.28