go back

South Dakota rates for HCPCS L2200

Addition to lower extremity, limited ankle motion, each joint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.06 / $42.06 / $42.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.65 / $42.06 / $48.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.15 / $39.15 / $58.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.13 / $70.13 / $87.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.82 / $72.53 / $295.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.26 / $40.90 / $69.83
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.99 / $58.92 / $102.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.35 / $60.87 / $128.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.57 / $69.73 / $82.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.92 / $35.63 / $60.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.49 / $52.49 / $52.49