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South Dakota rates for HCPCS L5690

Addition to lower extremity, below knee (BK), waist belt, padded and lined

Facilitymedian $126 · 10th–90th $98–$2140%50%10th90th$126Professionalmedian $115 · 10th–90th $56–$1860%10%10th90th$115$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $125.89 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $107.15 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $218.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $316.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $89.13 / $758.58
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $131.83 / $131.83
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $208.93
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $117.49 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $89.13 / $177.83
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49