go back

South Dakota rates for HCPCS L5684

Addition To Lower Extremity Below Knee Fork Strap

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.39 / $48.39 / $48.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.39 / $49.91 / $57.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.36 / $37.36 / $70.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.13 / $67.80 / $83.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.81 / $75.08 / $305.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.47 / $39.18 / $73.09
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.48 / $70.33 / $110.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.61 / $71.33 / $134.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.13 / $57.53 / $68.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.57 / $38.42 / $66.44
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.66 / $62.66 / $62.66