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South Dakota rates for HCPCS L5642

Addition to lower extremity, above knee (AK), leather socket

Facilitymedian $692 · 10th–90th $692–$1,6220%20%40%90th$692Professionalmedian $794 · 10th–90th $339–$1,1750%10%20%10th90th$794$500.0$1.0K$2.0K$5.0K

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
$691.83 / $691.83 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $691.83 / $977.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,174.90
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $954.99 / $2,630.27
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $616.60 / $4,897.79
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $831.76 / $831.76
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $1,778.28
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,000.00 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $616.60 / $954.99
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31