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South Dakota rates for HCPCS L5811

Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$793.64 / $793.64 / $793.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.22 / $793.64 / $1,107.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$612.94 / $612.94 / $1,012.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,098.38 / $1,098.38 / $1,372.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.15 / $1,151.54 / $4,719.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.46 / $692.61 / $1,133.84
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$841.67 / $1,012.24 / $1,679.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.51 / $1,026.49 / $2,032.67
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$945.77 / $1,107.28 / $1,316.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.94 / $582.27 / $942.77
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$901.82 / $901.82 / $901.82