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South Dakota rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Facilitymedian $355 · 10th–90th $309–$7080%20%40%10th90th$355Professionalmedian $355 · 10th–90th $174–$5620%10%10th90th$355$200.0$500.0$1.0K$2.0K

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
$309.03 / $354.81 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $331.13 / $416.87
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $457.09 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $616.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $426.58 / $1,148.15
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $302.00 / $2,187.76
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $467.74 / $467.74
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $758.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $426.58 / $562.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $288.40 / $478.63
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87