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South Dakota rates for HCPCS L1240

Addition to thoracic-lumbar-sacral orthosis (TLSO), (low profile), lumbar derotation pad

Facilitymedian $76 · 10th–90th $63–$1200%20%40%10th90th$76Professionalmedian $76 · 10th–90th $42–$1450%10%10th90th$76$50.0$100.0$200.0$500.0

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
$63.10 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $63.10 / $81.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $158.49
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $93.33 / $162.18
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $63.10 / $602.56
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $95.50 / $95.50
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $97.72
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $158.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $87.10 / $114.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $66.07 / $123.03
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11