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South Dakota rates for HCPCS L5795

Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)

Facilitymedian $1,096 · 10th–90th $1,072–$2,1380%20%40%10th90th$1,096Professionalmedian $1,072 · 10th–90th $759–$1,8620%20%10th90th$1,072$1.0K$2.0K$5.0K

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
$933.25 / $1,071.52 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,071.52 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,862.09
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,380.38 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $977.24 / $8,511.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,412.54 / $1,412.54
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $2,290.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,288.25 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $977.24 / $1,513.56
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93