go back

South Dakota rates for HCPCS L5699

All lower extremity prostheses, shoulder harness

Facilitymedian $204 · 10th–90th $170–$3720%20%40%10th90th$204Professionalmedian $204 · 10th–90th $98–$3550%20%10th90th$204$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 / $204.17 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $204.17 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $354.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $229.09 / $602.56
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $169.82 / $1,698.24
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $245.47 / $245.47
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $398.11
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $223.87 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $169.82 / $288.40
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78