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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
$261.98 / $261.98 / $261.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.79 / $242.96 / $261.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.89 / $243.89 / $391.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$437.25 / $441.62 / $546.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.45 / $390.73 / $1,827.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.59 / $226.54 / $421.82
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.83 / $391.88 / $682.05
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.95 / $397.39 / $748.85
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.45 / $347.09 / $412.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.84 / $196.85 / $314.95
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.13 / $349.13 / $349.13