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Custom Shaped Protective Cover, Hip Disarticulation

South Dakota rates for HCPCS L5707

Custom shaped protective cover, hip disarticulation

Rates data updated October 2026.

How much does Custom Shaped Protective Cover, Hip Disarticulation cost?

$1,660

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $1,660 for this service. The price depends on where it is billed: about $1,660 from a physician practice, and about $2,291 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,660$1,122 to $1,905
FacilityA hospital or hospital-owned outpatient department$2,291$1,514 to $2,692

How much rates vary

Facilitymedian $2,291 · 10th to 90th $1,175 to $4,365Professionalmedian $1,660 · 10th to 90th $813 to $2,188
$1K$2K$5Kfacility $2,291professional $1,660

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,348.96
Median
$1,621.81
Typical High
$1,621.81
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,949.84
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,905.46
Median
$2,089.30
Typical High
$2,630.27
Medica
Setting
Facility
Modifier
None
Typical Low
$1,174.90
Median
$2,691.53
Typical High
$4,365.16
Medica
Setting
Professional
Modifier
None
Typical Low
$660.69
Median
$1,122.02
Typical High
$8,317.64
Midlands
Setting
Professional
Modifier
None
Typical Low
$1,905.46
Median
$1,905.46
Typical High
$1,905.46
Midlands
Setting
Facility
Modifier
None
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$1,949.84
Midlands
Setting
Professional
Modifier
None
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$2,951.21
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$1,412.54
Median
$1,659.59
Typical High
$1,905.46
United
Setting
Professional
Modifier
None
Typical Low
$616.60
Median
$1,096.48
Typical High
$1,318.26
Wellmark
Setting
Professional
Modifier
None
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$1,737.80

Where South Dakota sits

The same service costs 2.1 times more in Wisconsin than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 6th of 51

$1,660

WI $1,820FL $871

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.