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South Dakota rates for HCPCS L1902

Ankle orthosis (AO), ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf

Facilitymedian $85 · 10th–90th $62$1070%20%10th90th$85Professionalmedian $74 · 10th–90th $52$1820%10%10th90th$74$50.0$100.0$200.0$500.0

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
$61.66 / $61.66 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $61.66 / $186.21
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $95.50 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $128.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $93.33 / $169.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $69.18 / $588.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $104.71 / $104.71
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $162.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $89.13 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $64.57 / $104.71
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33