go back

South Dakota rates for HCPCS L2500

Addition to lower extremity, thigh/weight bearing, gluteal/ischial weight bearing, ring

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $263.03 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $213.80 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $245.47 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $436.52 / $549.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $354.81 / $660.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $229.09 / $2,290.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $389.05 / $389.05
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $323.59 / $630.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $354.81 / $467.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $194.98 / $407.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $346.74 / $346.74