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South Dakota rates for HCPCS L1290

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

Facilitymedian $68 · 10th–90th $65–$1150%20%40%10th90th$68Professionalmedian $65 · 10th–90th $39–$1350%10%10th90th$65$50.0$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
$64.57 / $64.57 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $61.66 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $134.90
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $89.13 / $165.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $63.10 / $933.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $97.72 / $97.72
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $158.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $89.13 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $64.57 / $104.71
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10