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South Dakota rates for HCPCS L5694

Addition to lower extremity, above knee (AK), pelvic control belt, padded and lined

Facilitymedian $186 · 10th–90th $182–$3980%20%40%10th90th$186Professionalmedian $209 · 10th–90th $126–$3160%20%10th90th$209$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $181.97 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $316.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $239.88 / $645.65
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $165.96 / $1,513.56
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $239.88 / $239.88
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $436.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $245.47 / $323.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $165.96 / $257.04
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80