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South Dakota rates for HCPCS L5845

Addition, endoskeletal knee-shin system, stance flexion feature, adjustable

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $1,819.70 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,584.89 / $2,137.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $3,162.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $2,290.87 / $5,888.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,445.44 / $11,748.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,344.23 / $2,344.23
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $2,398.83 / $2,398.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $1,949.84 / $3,890.45
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,187.76 / $2,884.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,445.44 / $2,290.87
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,089.30 / $2,089.30