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South Dakota rates for HCPCS L3510

Orthopedic Shoe Addition Insole Rubber (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.48 / $24.48 / $24.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.02 / $24.34 / $24.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.27 / $24.27 / $38.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.88 / $40.88 / $51.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.03 / $41.13 / $164.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.19 / $22.70 / $38.45
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.04 / $38.56 / $60.43
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.57 / $39.09 / $73.66
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.70 / $34.77 / $41.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $18.32 / $29.61
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.29 / $33.29 / $33.29