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South Dakota rates for HCPCS L6955

Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

Facilitymedian $12,303 · 10th–90th $12,303–$31,6230%20%40%90th$12,303Professionalmedian $13,183 · 10th–90th $6,918–$20,8930%20%10th90th$13,183$5.0K$10.0K$20.0K$50.0K$100.0K

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
$12,302.69 / $12,302.69 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,918.31 / $12,022.64 / $18,620.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $9,332.54 / $16,218.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,982.44 / $16,982.44 / $20,892.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,302.69 / $18,620.87 / $51,286.14
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $95,499.26
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,182.57 / $15,848.93 / $15,848.93
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,182.57 / $13,182.57 / $33,884.42
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,848.93 / $19,054.61 / $25,118.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $11,481.54 / $16,982.44
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,125.38 / $14,125.38 / $14,125.38