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South Dakota rates for HCPCS L6920

Wrist Disarticulation External Power Self-Suspended Inner Socket Removable Forearm Shell Otto Bock Or Equal Switch Cables Two Batteries And One Charger Switch Control Of Terminal Device

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,470.41 / $8,470.41 / $8,470.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,033.63 / $8,470.41 / $9,508.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,541.83 / $6,541.83 / $9,913.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,723.63 / $11,723.63 / $14,654.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,507.89 / $14,314.99 / $42,519.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,879.03 / $6,337.86 / $10,301.62
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,242.49 / $9,913.01 / $15,371.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,299.84 / $10,052.53 / $18,943.55
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,121.82 / $9,508.64 / $11,302.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,128.94 / $6,020.97 / $9,506.79
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,831.59 / $8,831.59 / $8,831.59