go back

South Dakota rates for HCPCS L5682

Addition To Lower Extremity Below Knee Thigh Lacer Gluteal/Ischial Molded

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$628.72 / $628.72 / $628.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$628.72 / $630.11 / $733.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$485.57 / $485.57 / $888.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.38 / $879.08 / $1,087.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$566.66 / $966.31 / $3,853.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.04 / $499.30 / $922.88
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$738.42 / $888.06 / $1,440.44
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$727.32 / $900.56 / $1,697.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.12 / $733.02 / $871.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.04 / $499.30 / $825.68
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$791.18 / $791.18 / $791.18