go back

South Dakota rates for HCPCS L5680

Addition To Lower Extremity Below Knee Thigh Lacer Nonmolded

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$305.99 / $305.99 / $305.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.99 / $312.92 / $435.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.28 / $228.28 / $441.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.38 / $427.61 / $529.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$289.89 / $470.54 / $1,903.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.68 / $289.06 / $458.31
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.70 / $441.02 / $701.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.17 / $447.23 / $842.77
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.03 / $435.55 / $517.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.88 / $296.67 / $401.85
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$392.91 / $392.91 / $392.91