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South Dakota rates for HCPCS L1900

Ankle-foot orthosis (AFO), spring wire, dorsiflexion assist calf band, custom fabricated

Facilitymedian $295 · 10th–90th $240–$4070%20%40%10th90th$295Professionalmedian $240 · 10th–90th $174–$4370%20%10th90th$240$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
$239.88 / $239.88 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $223.87 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $501.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $331.13 / $616.60
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $218.78 / $1,949.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $346.74 / $346.74
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $588.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $331.13 / $436.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $234.42 / $389.05
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03