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South Dakota rates for HCPCS L8001

Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type

Facilitymedian $126 · 10th–90th $112–$2510%20%40%10th90th$126Professionalmedian $126 · 10th–90th $66–$2040%10%10th90th$126$100.0$200.0$500.0

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
$112.20 / $125.89 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $123.03 / $147.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $218.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $151.36 / $407.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $102.33 / $758.58
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $165.96 / $165.96
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $275.42
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $151.36 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $102.33 / $169.82
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91