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Vacuum Pump, Limb Volume and Moisture Evacuation

South Dakota rates for HCPCS L5781

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

Rates data updated October 2026.

How much does Vacuum Pump, Limb Volume and Moisture Evacuation cost?

$4,786

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $4,786 for this service. The price depends on where it is billed: about $4,786 from a physician practice, and about $6,761 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$4,786$3,236 to $5,248
FacilityA hospital or hospital-owned outpatient department$6,761$3,548 to $8,128

How much rates vary

Facilitymedian $6,761 · 10th to 90th $3,311 to $13,183Professionalmedian $4,786 · 10th to 90th $2,089 to $6,457
$2K$5K$10K$20Kfacility $6,761professional $4,786

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
$3,548.13
Median
$3,548.13
Typical High
$3,548.13
Aetna
Setting
Professional
Modifier
None
Typical Low
$3,715.35
Median
$4,786.30
Typical High
$4,786.30
Cigna
Setting
Facility
Modifier
None
Typical Low
$2,884.03
Median
$2,884.03
Typical High
$5,370.32
Cigna
Setting
Professional
Modifier
None
Typical Low
$5,248.07
Median
$5,623.41
Typical High
$7,079.46
Medica
Setting
Facility
Modifier
None
Typical Low
$3,311.31
Median
$8,128.31
Typical High
$13,182.57
Medica
Setting
Professional
Modifier
None
Typical Low
$1,949.84
Median
$3,235.94
Typical High
$24,547.09
Midlands
Setting
Professional
Modifier
None
Typical Low
$5,248.07
Median
$5,248.07
Typical High
$5,248.07
Midlands
Setting
Facility
Modifier
None
Typical Low
$5,370.32
Median
$5,370.32
Typical High
$5,370.32
Midlands
Setting
Professional
Modifier
None
Typical Low
$4,365.16
Median
$4,365.16
Typical High
$8,709.64
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$4,168.69
Median
$4,897.79
Typical High
$5,623.41
United
Setting
Professional
Modifier
None
Typical Low
$1,778.28
Median
$3,235.94
Typical High
$3,801.89
Wellmark
Setting
Professional
Modifier
None
Typical Low
$4,786.30
Median
$4,786.30
Typical High
$4,786.30

Where South Dakota sits

The same service costs 2.4 times more in Montana than in Delaware. 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· 7th of 51

$4,786

MT $5,012DE $2,089

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.