go back

South Dakota rates for HCPCS L0976

Lumbar-Sacral Orthotic (Lso), Full Corset

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.17 / $125.17 / $125.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.17 / $126.09 / $156.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.53 / $116.53 / $220.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.88 / $220.78 / $261.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$156.24 / $232.12 / $947.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.59 / $137.52 / $228.56
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$183.58 / $220.78 / $345.71
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.83 / $223.89 / $421.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.65 / $223.20 / $265.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.37 / $104.85 / $190.04
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.70 / $196.70 / $196.70