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South Dakota rates for HCPCS L5631

Addition to lower extremity, above knee (AK) or knee disarticulation, acrylic socket

Facilitymedian $447 · 10th–90th $437–$8710%20%40%10th90th$447Professionalmedian $447 · 10th–90th $309–$7240%10%20%10th90th$447$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
$380.19 / $436.52 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $436.52 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $758.58
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $562.34 / $1,412.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $398.11 / $3,467.37
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $575.44 / $575.44
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $954.99
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $524.81 / $691.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $398.11 / $616.60
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86