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South Dakota rates for HCPCS L5460

Immediate Post Surgical Or Early Fitting Application Of Non- Weight Bearing Rigid Dressing Above Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$627.23 / $627.23 / $627.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.79 / $627.23 / $672.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$484.42 / $484.42 / $852.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$868.13 / $868.13 / $1,085.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$582.02 / $842.50 / $3,319.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.39 / $458.15 / $885.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$708.74 / $852.39 / $1,255.97
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$698.10 / $864.37 / $1,628.88
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.52 / $672.63 / $799.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.66 / $491.95 / $776.76
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.40 / $759.40 / $759.40