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South Dakota rates for HCPCS L5613

Addition to lower extremity, endoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with hydraulic swing phase control

Facilitymedian $2,512 · 10th–90th $2,455–$6,0260%20%40%10th90th$2,512Professionalmedian $2,818 · 10th–90th $1,318–$4,2660%10%20%10th90th$2,818$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,454.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,454.71 / $3,630.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $4,265.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,715.35 / $9,772.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,344.23 / $18,620.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,890.45 / $3,981.07
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $6,606.93
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,715.35 / $4,897.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $2,344.23 / $3,467.37
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13