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South Dakota rates for HCPCS L3649

Orthopedic Shoe Modification Addition Or Transfer Not Otherwise Specified (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.00 / $11.00 / $11.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.89 / $25.48 / $25.48