go back

South Dakota rates for HCPCS L6645

Upper extremity addition, shoulder flexion-abduction joint, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.17 / $368.17 / $368.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.95 / $368.17 / $374.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$305.27 / $305.27 / $446.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.41 / $509.63 / $637.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.77 / $433.57 / $2,036.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.65 / $254.87 / $464.21
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.42 / $446.70 / $735.29
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.83 / $452.98 / $853.61
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.60 / $374.18 / $444.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.66 / $254.87 / $339.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.97 / $397.97 / $397.97