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South Dakota rates for HCPCS L0625

Lumbar orthosis (LO), flexible, provides lumbar support, posterior extends from L-1 to below L-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf

Facilitymedian $38 · 10th–90th $33–$740%20%10th90th$38Professionalmedian $37 · 10th–90th $22–$590%10%10th90th$37$10.0$20.0$50.0$100.0$200.0

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
$33.11 / $33.11 / $33.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $33.11 / $37.15
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $47.86 / $58.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $56.23 / $102.33
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $42.66 / $275.42
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $60.26
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $120.23
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $45.71 / $56.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $41.69 / $56.23
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48