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South Dakota rates for HCPCS L1852

Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf

Facilitymedian $575 · 10th–90th $501–$1,1220%20%40%10th90th$575Professionalmedian $603 · 10th–90th $380–$8910%10%20%10th90th$603$200.0$500.0$1.0K$2.0K

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
$501.19 / $501.19 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $501.19 / $691.83
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $724.44 / $891.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $851.14 / $1,513.56
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $630.96 / $4,168.69
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $891.25 / $891.25
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $1,698.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $691.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $616.60 / $812.83
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33