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South Dakota rates for HCPCS L5535

Preparatory Below Knee Ptb Type Socket Non-Alignable System No Cover Sach Foot Prefabricated Adjustable Open End Socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,955.99 / $1,955.99 / $1,955.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,907.25 / $1,955.99 / $1,987.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,271.83 / $1,271.83 / $2,688.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,614.79 / $2,707.13 / $3,383.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,719.90 / $2,621.06 / $11,043.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$810.87 / $1,353.90 / $2,793.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,235.05 / $2,688.02 / $3,905.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,201.52 / $2,725.87 / $5,136.78
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,697.78 / $1,987.68 / $2,362.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$795.07 / $1,015.43 / $1,692.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,394.78 / $2,394.78 / $2,394.78