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South Dakota rates for HCPCS L1040

Addition To Ctlso Or Scoliosis Orthosis Lumbar Or Lumbar Rib Pad

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.23 / $74.23 / $74.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.82 / $57.60 / $74.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.78 / $66.78 / $97.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.03 / $123.75 / $154.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.71 / $101.54 / $471.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.02 / $57.38 / $104.31
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.26 / $97.74 / $168.66
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.03 / $99.09 / $186.75
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.31 / $85.83 / $102.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.33 / $51.16 / $77.88
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.07 / $87.07 / $87.07