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South Dakota rates for HCPCS L1210

Addition to thoracic-lumbar-sacral orthosis (TLSO), (low profile), lateral thoracic extension

Facilitymedian $257 · 10th–90th $204–$4790%20%10th90th$257Professionalmedian $269 · 10th–90th $132–$4270%10%20%10th90th$269$100.0$200.0$500.0$1.0K

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
$204.17 / $204.17 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $204.17 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $426.58
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $346.74 / $741.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $234.42 / $1,949.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $323.59 / $323.59
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $707.95
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $389.05 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $234.42 / $346.74
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40