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South Dakota rates for HCPCS L6642

Upper extremity addition, excursion amplifier, lever type

Facilitymedian $288 · 10th–90th $219–$4900%20%40%10th90th$288Professionalmedian $251 · 10th–90th $123–$4680%10%10th90th$251$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $288.40 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $251.19 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $501.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $302.00 / $691.83
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $199.53 / $1,659.59
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $354.81 / $354.81
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $467.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $263.03 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $199.53 / $407.38
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23