go back

South Dakota rates for HCPCS L5810

Addition, endoskeletal knee-shin system, single axis, manual lock

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.10 / $575.10 / $575.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.08 / $575.10 / $633.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$483.85 / $483.85 / $642.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.13 / $796.13 / $995.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$477.37 / $751.19 / $3,115.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.47 / $431.56 / $693.54
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$534.47 / $642.79 / $1,121.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.03 / $651.84 / $1,228.33
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$541.16 / $633.58 / $753.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.26 / $388.70 / $539.45
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572.66 / $572.66 / $572.66