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South Dakota rates for HCPCS L4070

Replace Proximal And Distal Upright For Kafo

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$220.29 / $220.29 / $220.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.73 / $220.29 / $226.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$205.09 / $205.09 / $396.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.50 / $371.18 / $459.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$246.40 / $366.27 / $1,717.61
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.31 / $202.10 / $395.43
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.76 / $396.59 / $608.42
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.82 / $402.18 / $757.88
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.45 / $309.62 / $368.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.85 / $184.53 / $376.29
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.51 / $342.51 / $342.51