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South Dakota rates for HCPCS L1280

Addi To Thoracic-Lumbar-Sacral Orthotic (Tlso), (Low Profile), R

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.15 / $73.15 / $73.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.06 / $66.44 / $73.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.27 / $73.27 / $106.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.88 / $121.88 / $152.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.44 / $112.28 / $510.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.72 / $61.95 / $115.35
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.89 / $106.91 / $186.52
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.55 / $108.42 / $204.29
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.06 / $94.91 / $112.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.96 / $56.57 / $80.81
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.25 / $95.25 / $95.25