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South Dakota rates for HCPCS L5785

Addition Exoskeletal System Below Knee Ultra-Light Material (Titanium Carbon Fiber Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$522.32 / $522.32 / $522.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.71 / $522.32 / $608.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.66 / $389.66 / $685.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$723.00 / $723.00 / $903.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$514.44 / $801.05 / $3,225.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.43 / $414.80 / $740.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$570.35 / $685.96 / $1,196.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$561.79 / $695.60 / $1,310.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.16 / $608.98 / $723.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.59 / $414.80 / $518.50
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611.13 / $611.13 / $611.13