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South Dakota rates for HCPCS L2006

Knee Ankle Foot Device Any Material Single Or Double Upright Swing And/Or Stance Phase Microprocessor Control With Adjustability Includes All Components (E.G. Sensors Batteries Charger) Any Type Activation With Or Without Ankle Joint(S) Custom Fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,933.26 / $26,933.26 / $26,933.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24,267.05 / $26,933.26 / $26,989.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42,492.59 / $42,492.59 / $42,492.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44,937.75 / $44,937.75 / $56,172.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32,413.12 / $45,612.95 / $182,487.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,286.09 / $27,657.74 / $49,685.54
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42,368.25 / $42,492.59 / $81,122.22
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42,368.25 / $42,492.59 / $52,659.26
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38,557.01 / $39,482.40 / $52,258.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,776.64 / $23,186.58 / $36,137.94
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37,857.04 / $37,857.04 / $37,857.04