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South Dakota rates for HCPCS L5698

Addition to lower extremity, above knee (AK) or knee disarticulation, Silesian bandage

Facilitymedian $120 · 10th–90th $105–$2090%20%40%10th90th$120Professionalmedian $120 · 10th–90th $62–$2000%10%20%10th90th$120$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
$91.20 / $120.23 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $120.23 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $208.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $128.82 / $338.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $95.50 / $794.33
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $151.36
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $223.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $125.89 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $95.50 / $169.82
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90