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South Dakota rates for HCPCS L5695

Addition to lower extremity, above knee (AK), pelvic control, sleeve suspension, neoprene or equal, each

Facilitymedian $174 · 10th–90th $162–$3890%20%40%10th90th$174Professionalmedian $174 · 10th–90th $115–$2820%20%10th90th$174$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
$162.18 / $162.18 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $281.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $234.42 / $630.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $154.88 / $1,288.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $213.80 / $213.80
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $426.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $239.88 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $154.88 / $229.09
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55