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South Dakota rates for HCPCS L4361

Walking Boot Pneumatic And/Or Vacuum With Or Without Joints With Or Without Interface Materialprefabricated Off-The-Shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.73 / $216.74 / $216.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.31 / $195.31 / $230.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.16 / $291.73 / $343.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.50 / $361.50 / $451.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219.74 / $388.89 / $1,620.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.11 / $267.54 / $370.23
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$285.31 / $343.13 / $598.64
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.13 / $356.59 / $904.42
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.79 / $328.73 / $390.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.85 / $167.94 / $279.89
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.33 / $296.33 / $296.33