go back

South Dakota rates for HCPCS L1220

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

Facilitymedian $219 · 10th–90th $191–$3390%20%40%10th90th$219Professionalmedian $204 · 10th–90th $126–$4170%20%10th90th$204$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
$190.55 / $199.53 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $199.53 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $416.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $263.03 / $489.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $177.83 / $1,659.59
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $281.84 / $281.84
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $467.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $263.03 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $190.55 / $323.59
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19