go back

South Dakota rates for HCPCS L6714

Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,338.02 / $1,338.02 / $1,338.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,240.68 / $1,338.02 / $1,577.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.71 / $891.71 / $1,748.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,851.75 / $1,851.75 / $2,314.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,140.61 / $2,665.33 / $7,438.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.38 / $1,074.25 / $1,817.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,453.91 / $1,748.58 / $2,738.57
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,432.10 / $1,773.20 / $3,341.51
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,347.10 / $1,577.12 / $1,874.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.29 / $1,074.25 / $1,693.71
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,557.83 / $1,557.83 / $1,557.83