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South Dakota rates for HCPCS L1250

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

Facilitymedian $71 · 10th–90th $62–$1120%20%10th90th$71Professionalmedian $66 · 10th–90th $40–$1380%10%10th90th$66$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
$58.88 / $66.07 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $57.54 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $138.04
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $83.18 / $151.36
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $58.88 / $457.09
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $89.13 / $89.13
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $144.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $81.28 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $61.66 / $107.15
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43