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Prosthetic Sheath/Sock with Gel Cushion, Below or Above Knee

South Dakota rates for HCPCS L8417

Prosthetic sheath/sock, including a gel cushion layer, below knee (BK) or above knee (AK), each

Rates data updated July 2026.

Facilitymedian $89 · 10th–90th $62$1780%10%10th90th$89Professionalmedian $89 · 10th–90th $68$1320%20%10th90th$89$50.0$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
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$75.86
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$102.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$131.83
Medica
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$93.33
Typical High
$245.47
Medica
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$61.66
Typical High
$457.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$100.00
Typical High
$100.00
Midlands
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Midlands
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$165.96
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$120.23
United
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$60.26
Typical High
$67.61
United
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$61.66
Typical High
$107.15
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20