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South Dakota rates for HCPCS L5450

Immediate postsurgical or early fitting, application of nonweight bearing rigid dressing, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.21 / $478.21 / $478.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.09 / $478.21 / $574.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$305.54 / $305.54 / $649.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$661.88 / $661.88 / $827.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$477.56 / $630.80 / $2,506.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.28 / $386.90 / $661.71
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$540.34 / $649.86 / $938.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.24 / $658.99 / $1,241.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.53 / $574.29 / $682.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.01 / $325.26 / $488.97
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$578.96 / $578.96 / $578.96