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South Dakota rates for HCPCS L5703

Ankle, Symes, molded to patient model, socket without solid ankle cushion heel (SACH) foot, replacement only

Facilitymedian $2,570 · 10th–90th $2,291–$4,4670%50%10th90th$2,570Professionalmedian $2,570 · 10th–90th $1,413–$3,7150%20%10th90th$2,570$1.0K$2.0K$5.0K$10.0K

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
$1,995.26 / $2,570.40 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,454.71 / $2,630.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,691.53 / $7,244.36
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,905.46 / $15,848.93
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,754.23 / $2,754.23
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $4,897.79
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,691.53 / $3,630.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,905.46 / $3,548.13
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,454.71