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South Dakota rates for HCPCS L5321

Above Knee Molded Socket Open End Sach Foot Endoskeletal System Single Axis Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,612.45 / $3,612.45 / $3,612.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,078.90 / $3,612.45 / $3,852.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,481.10 / $2,481.10 / $4,339.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,999.88 / $4,999.88 / $6,249.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,333.39 / $5,328.40 / $20,983.29
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,571.57 / $2,823.40 / $4,681.93
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,608.07 / $4,339.32 / $7,570.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,553.93 / $4,400.39 / $8,292.37
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,290.52 / $3,852.38 / $4,579.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,540.95 / $2,624.05 / $3,698.95
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,865.94 / $3,865.94 / $3,865.94