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South Dakota rates for HCPCS L5010

Partial foot, molded socket, ankle height, with toe filler

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,621.81 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,174.90 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $912.01 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,818.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,819.70 / $4,265.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,071.52 / $9,120.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,862.09 / $1,862.09
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $1,905.46 / $1,905.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $2,884.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,584.89 / $2,137.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,071.52 / $1,949.84
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,659.59 / $1,659.59