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South Dakota rates for HCPCS L5712

Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.19 / $433.19 / $433.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$406.88 / $433.19 / $505.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$364.44 / $364.44 / $573.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.63 / $599.63 / $749.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.61 / $597.70 / $2,756.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.04 / $344.02 / $613.82
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$476.82 / $573.45 / $992.48
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.66 / $581.52 / $1,095.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.39 / $505.06 / $600.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.02 / $344.02 / $443.56
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.89 / $510.89 / $510.89