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South Dakota rates for HCPCS L5614

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

Facilitymedian $1,698 · 10th–90th $1,514–$3,9810%20%40%10th90th$1,698Professionalmedian $1,698 · 10th–90th $891–$2,7540%20%10th90th$1,698$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
$1,513.56 / $1,698.24 / $1,698.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,659.59 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,951.21
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,089.30 / $5,623.41
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,380.38 / $14,454.40
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,238.72 / $2,238.72
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $3,715.35
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,041.74 / $2,754.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,380.38 / $2,398.83
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26