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South Dakota rates for HCPCS L5711

Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.82 / $606.82 / $606.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.32 / $606.82 / $612.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$468.67 / $468.67 / $755.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$798.89 / $840.00 / $1,050.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$481.46 / $798.81 / $3,286.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.68 / $416.88 / $785.51
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$628.50 / $755.89 / $1,202.68
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.05 / $766.51 / $1,444.45
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$522.76 / $612.03 / $727.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.81 / $416.88 / $743.82
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.43 / $673.43 / $673.43