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Molded Distal Cushion, Below-Knee

South Dakota rates for HCPCS L5668

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

Rates data updated July 2026.

How much does Molded Distal Cushion, Below-Knee cost?

$117

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $117 for this service. The price depends on where it is billed: about $117 from a physician practice, and about $123 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$117$112 to $158
FacilityA hospital or hospital-owned outpatient department$123$102 to $155

How much rates vary

Facilitymedian $123 · 10th to 90th $89 to $234Professionalmedian $117 · 10th to 90th $95 to $200
$50$100$200$500facility $123professional $117

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$114.82
Typical High
$117.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$138.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$199.53
Medica
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$128.82
Typical High
$323.59
Medica
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$93.33
Typical High
$794.33
Midlands
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$134.90
Typical High
$134.90
Midlands
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Midlands
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$218.78
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$120.23
Typical High
$162.18
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$91.20
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$93.33
Typical High
$162.18
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03

Where South Dakota sits

The same service costs 3.2 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 6th of 51

$117

HI $186DE $57.54

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.