go back

South Dakota rates for HCPCS L5670

Addition To Lower Extremity Below Knee Molded Supracondylar Suspension (Pts Or Similar)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.79 / $272.79 / $272.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.19 / $272.79 / $424.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$203.51 / $203.51 / $358.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$377.63 / $377.63 / $472.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.41 / $441.03 / $1,717.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.22 / $257.69 / $432.27
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$297.88 / $358.26 / $625.02
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.38 / $370.16 / $778.48
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$362.22 / $424.07 / $504.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.75 / $244.81 / $386.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.18 / $319.18 / $319.18