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South Dakota rates for HCPCS L5654

Addition to lower extremity, socket insert, Symes, (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $398 · 10th–90th $339–$6760%50%10th90th$398Professionalmedian $389 · 10th–90th $209–$5500%10%20%10th90th$389$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
$288.40 / $398.11 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $389.05 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $691.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $407.38 / $1,071.52
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $302.00 / $2,344.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $467.74 / $467.74
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $724.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $398.11 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $302.00 / $549.54
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87