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South Dakota rates for HCPCS L5668

Addition to lower extremity, below knee (BK), molded distal cushion

Facilitymedian $115 · 10th–90th $102–$2000%50%10th90th$115Professionalmedian $115 · 10th–90th $71–$1780%20%10th90th$115$50.0$100.0$200.0$500.0

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
$87.10 / $114.82 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $112.20 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $199.53
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $128.82 / $323.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $93.33 / $794.33
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $134.90 / $134.90
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $218.78
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $120.23 / $162.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $93.33 / $162.18
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23