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South Dakota rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $631 · 10th–90th $513–$1,1750%50%10th90th$631Professionalmedian $631 · 10th–90th $282–$9330%10%20%10th90th$631$200.0$500.0$1.0K$2.0K

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
$512.86 / $630.96 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $616.60 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $1,096.48
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $724.44 / $1,905.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $478.63 / $3,630.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $812.83 / $812.83
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $1,288.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $707.95 / $933.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $478.63 / $891.25
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44