go back

South Dakota rates for HCPCS L8400

Prosthetic Sheath Below Knee Each (Special Coverage Instructions Apply. See Mcm: 2133)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.82 / $15.82 / $15.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.82 / $17.14 / $18.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.44 / $14.44 / $24.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.75 / $21.97 / $27.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.02 / $25.21 / $101.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.53 / $12.57 / $25.13
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.11 / $24.18 / $36.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.80 / $24.53 / $46.23
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.76 / $18.45 / $21.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.38 / $12.57 / $18.89
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.54 / $21.54 / $21.54