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South Dakota rates for HCPCS L5678

Additions to lower extremity, below knee (BK), joint covers, pair

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.92 / $39.92 / $39.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.92 / $41.87 / $60.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.78 / $29.78 / $59.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.13 / $55.68 / $68.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.86 / $63.00 / $253.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.71 / $37.71 / $59.86
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.06 / $59.02 / $91.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.88 / $59.84 / $112.75
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.74 / $60.56 / $71.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $35.82 / $51.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.58 / $52.58 / $52.58