go back

South Dakota rates for HCPCS L6100

Below elbow, molded socket, flexible elbow hinge, triceps pad

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,543.56 / $2,543.56 / $2,543.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,206.02 / $2,371.67 / $2,543.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,964.43 / $1,964.43 / $3,109.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,095.77 / $3,520.50 / $4,400.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,052.17 / $2,986.09 / $12,160.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.52 / $1,615.47 / $3,175.51
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,585.17 / $3,109.12 / $4,432.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,546.39 / $3,152.87 / $5,941.45
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,025.78 / $2,371.67 / $2,819.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$902.34 / $1,536.58 / $2,019.34
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,769.94 / $2,769.94 / $2,769.94