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South Dakota rates for HCPCS L5655

Addition to lower extremity, socket insert, below knee (BK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $288 · 10th–90th $269$5250%50%10th90th$288Professionalmedian $288 · 10th–90th $162$4680%20%10th90th$288$100.0$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
$229.09 / $288.40 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $288.40 / $346.74
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $489.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $323.59 / $851.14
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $245.47 / $2,041.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $346.74 / $346.74
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $575.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $316.23 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $245.47 / $398.11
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03