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South Dakota rates for HCPCS L5644

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $588.84 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $588.84 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $1,023.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $933.25 / $2,511.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $537.03 / $4,677.35
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $851.14 / $851.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $870.96 / $870.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $707.95 / $1,698.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $954.99 / $1,258.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $537.03 / $794.33
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $758.58 / $758.58