go back

South Dakota rates for HCPCS L6320

Shoulder Disarticulation Passive Restoration (Shoulder Cap Only)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,119.94 / $2,119.94 / $2,119.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,119.94 / $2,134.52 / $2,135.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,637.27 / $1,637.27 / $3,008.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,926.37 / $2,934.00 / $3,667.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,868.94 / $2,688.67 / $10,648.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$871.16 / $1,454.57 / $2,635.73
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,501.37 / $3,008.32 / $3,936.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,354.54 / $3,050.67 / $5,748.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,824.01 / $2,135.44 / $2,538.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$801.22 / $1,454.57 / $2,434.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,680.14 / $2,680.14 / $2,680.14