go back

South Dakota rates for HCPCS L3580

Orthopedic Shoe Addition Convert Instep To Velcro Closure (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.30 / $54.30 / $54.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.85 / $54.00 / $54.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.62 / $43.62 / $85.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.75 / $90.75 / $113.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.62 / $91.26 / $363.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.47 / $50.35 / $85.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.14 / $85.54 / $133.99
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.08 / $86.76 / $163.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.89 / $77.14 / $91.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.27 / $39.40 / $65.68
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.87 / $73.87 / $73.87