go back

South Dakota rates for HCPCS L4080

Replace metal bands KAFO, proximal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $83.18 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $67.61 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $85.11 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $173.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $125.89 / $213.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $72.44 / $660.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $151.36 / $151.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $154.88 / $154.88
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $204.17
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $114.82 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $66.07 / $128.82
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83