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South Dakota rates for HCPCS L1200

Thoracic-lumbar-sacral orthosis (TLSO), inclusive of furnishing initial orthosis only

Facilitymedian $1,549 · 10th–90th $1,514–$2,6300%20%40%10th90th$1,549Professionalmedian $1,585 · 10th–90th $912–$2,9510%20%10th90th$1,585$1.0K$2.0K$5.0K$10.0K

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
$1,513.56 / $1,513.56 / $1,513.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,513.56 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $3,090.30
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,137.96 / $3,981.07
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,348.96 / $13,803.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,238.72 / $2,238.72
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $3,801.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,137.96 / $2,818.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,412.54 / $2,398.83
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26