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Above-Knee Pelvic Control Belt, Light

South Dakota rates for HCPCS L5692

Addition to lower extremity, above knee (AK), pelvic control belt, light

Rates data updated July 2026.

Facilitymedian $170 · 10th–90th $120$3240%10%20%10th90th$170Professionalmedian $162 · 10th–90th $132$2290%20%10th90th$162$100.0$200.0$500.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$154.88
Typical High
$162.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$213.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$229.09
Medica
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$177.83
Typical High
$446.68
Medica
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$123.03
Typical High
$1,174.90
Midlands
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$208.93
Typical High
$208.93
Midlands
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
Midlands
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$295.12
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$165.96
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$120.23
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$123.03
Typical High
$186.21
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55