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Legg Perthes Orthosis, (Patten Bottom), Custom Fabricated

South Dakota rates for HCPCS L1755

Legg Perthes orthosis, (Patten bottom type), custom fabricated

Rates data updated July 2026.

Facilitymedian $1,820 · 10th–90th $1,259$2,5120%10%10th90th$1,820Professionalmedian $1,549 · 10th–90th $1,148$3,1620%10%20%10th90th$1,549$1.0K$2.0K$5.0K$10.0K

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
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$1,288.25
Typical High
$1,288.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,288.25
Typical High
$1,548.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,380.38
Median
$1,380.38
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$2,511.89
Typical High
$3,162.28
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$1,819.70
Typical High
$3,311.31
Medica
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,288.25
Typical High
$11,481.54
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$1,995.26
Typical High
$1,995.26
Midlands
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$3,162.28
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$1,778.28
Typical High
$2,344.23
United
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,047.13
Typical High
$1,479.11
United
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,348.96
Typical High
$2,511.89
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,819.70
Median
$1,819.70
Typical High
$1,819.70