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South Dakota rates for HCPCS L5781

Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system

Facilitymedian $4,074 · 10th–90th $3,631–$8,1280%20%40%10th90th$4,074Professionalmedian $4,074 · 10th–90th $2,138–$6,4570%10%20%10th90th$4,074$2.0K$5.0K$10.0K$20.0K

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
$3,548.13 / $4,073.80 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,981.07 / $4,786.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $5,623.41 / $7,079.46
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $5,011.87 / $13,182.57
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,311.31 / $24,547.09
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $5,248.07 / $5,248.07
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $5,370.32
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $8,709.64
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,897.79 / $6,456.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,311.31 / $5,623.41
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,677.35 / $4,677.35 / $4,677.35