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South Dakota rates for HCPCS L3620

Transfer Of An Orthosis From One Shoe To Another Solid Stirrup Existing (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.88 / $63.88 / $63.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.48 / $63.52 / $63.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.32 / $51.32 / $100.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.50 / $106.50 / $133.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.38 / $107.35 / $428.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.02 / $59.23 / $100.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.69 / $100.64 / $157.63
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.43 / $102.06 / $192.34
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.52 / $90.74 / $107.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.08 / $46.36 / $77.26
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.92 / $86.92 / $86.92