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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
$782.14 / $782.14 / $782.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$782.14 / $782.98 / $947.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$583.49 / $583.49 / $1,103.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,082.63 / $1,093.45 / $1,353.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$781.08 / $1,194.85 / $4,826.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.53 / $701.92 / $1,108.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$917.54 / $1,103.51 / $1,791.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$903.77 / $1,119.03 / $2,108.79
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$809.31 / $947.50 / $1,126.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.76 / $621.15 / $806.74
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$983.13 / $983.13 / $983.13