go back

South Dakota rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Facilitymedian $407 · 10th–90th $372–$7240%50%10th90th$407Professionalmedian $407 · 10th–90th $251–$6920%20%10th90th$407$200.0$500.0$1.0K$2.0K

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
$316.23 / $407.38 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $407.38 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $691.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $467.74 / $1,174.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $331.13 / $2,884.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $478.63 / $478.63
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $776.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $436.52 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $331.13 / $562.34
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58