go back

South Dakota rates for HCPCS L0641

Lumbar orthosis (LO), sagittal control, with rigid posterior panel(s), 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 padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Facilitymedian $54 · 10th–90th $47–$1050%20%10th90th$54Professionalmedian $52 · 10th–90th $31–$830%10%20%10th90th$52$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
$46.77 / $46.77 / $46.77
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $46.77 / $52.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $83.18
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $79.43 / $144.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $63.10 / $389.05
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $85.11 / $85.11
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $169.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $64.57 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $58.88 / $75.86
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13