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South Dakota rates for HCPCS L6915

Hand Restoration (Shading And Measurements Included) Replacement Glove For Above

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$819.76 / $819.76 / $819.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.77 / $775.77 / $819.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$644.36 / $644.36 / $1,093.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,063.56 / $1,134.75 / $1,418.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$679.25 / $966.31 / $4,034.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.33 / $499.81 / $1,088.42
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$909.11 / $1,093.35 / $1,441.92
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$862.52 / $1,108.74 / $2,089.39
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.75 / $733.77 / $872.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.51 / $499.81 / $891.78
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$974.08 / $974.08 / $974.08