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South Dakota rates for HCPCS L5950

Addition, endoskeletal system, above knee (AK), ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $776.25 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $707.95 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $588.84 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,348.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $1,071.52 / $2,570.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $707.95 / $6,165.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,096.48 / $1,096.48
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,122.02
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $912.01 / $1,737.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $977.24 / $1,288.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $645.65 / $1,000.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $977.24 / $977.24