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South Dakota rates for HCPCS L5600

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, laminated socket, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $5,248.07 / $5,248.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $3,890.45 / $5,754.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $6,025.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,244.36 / $7,244.36 / $9,120.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $5,754.40 / $14,125.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $3,548.13 / $40,738.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $5,888.44 / $5,888.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,025.60 / $6,025.60 / $6,025.60
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $9,549.93
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $5,370.32 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $3,548.13 / $6,456.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $5,248.07 / $5,248.07