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South Dakota rates for HCPCS L5020

Partial foot, molded socket, tibial tubercle height, with toe filler

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,536.78 / $2,536.78 / $2,536.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,856.46 / $2,536.78 / $2,746.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,486.28 / $1,486.28 / $2,616.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,511.13 / $3,511.13 / $4,388.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,040.76 / $3,061.35 / $12,494.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,120.50 / $1,870.90 / $2,823.03
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,175.53 / $2,616.44 / $4,564.56
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,368.98 / $2,653.27 / $5,042.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,346.08 / $2,746.67 / $3,264.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$929.13 / $1,787.92 / $2,823.03
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,331.01 / $2,331.01 / $2,331.01