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South Dakota rates for HCPCS L5656

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

Facilitymedian $437 · 10th–90th $347–$7590%20%40%10th90th$437Professionalmedian $437 · 10th–90th $200–$6460%10%10th90th$437$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
$331.13 / $436.52 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $436.52 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $758.58
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $467.74 / $1,230.27
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $338.84 / $2,951.21
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $549.54 / $549.54
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $831.76
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $457.09 / $602.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $338.84 / $602.56
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78