go back

South Dakota rates for HCPCS L6110

Below elbow, molded socket (Muenster or Northwestern suspension types)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,690.92 / $2,690.92 / $2,690.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,388.67 / $2,447.67 / $2,690.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,787.17 / $1,787.17 / $3,366.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,724.50 / $3,724.50 / $4,655.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,117.92 / $3,158.27 / $13,048.73
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$998.52 / $1,667.23 / $3,169.97
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,799.20 / $3,366.53 / $4,701.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,757.22 / $3,413.91 / $6,433.37
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,090.67 / $2,447.67 / $2,909.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$957.08 / $1,629.79 / $2,171.27
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,999.27 / $2,999.27 / $2,999.27