go back

South Dakota rates for HCPCS L8600

Implantable breast prosthesis, silicone or equal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$837.02 / $837.02 / $837.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.96 / $975.89 / $5,016.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$666.06 / $666.06 / $824.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,158.38 / $1,158.38 / $1,447.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$554.55 / $1,617.23 / $3,903.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.12 / $593.02 / $938.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$685.51 / $824.44 / $1,438.30
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$746.46 / $851.83 / $1,791.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$833.56 / $975.89 / $1,160.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.77 / $498.55 / $830.91
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$734.50 / $734.50 / $734.50