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Ankle-Foot Orthosis, Single Upright with Stop

South Dakota rates for HCPCS L1920

Ankle-foot orthosis (AFO), single upright with static or adjustable stop (Phelps or Perlstein type), custom fabricated

Rates data updated October 2026.

How much does Ankle-Foot Orthosis, Single Upright with Stop cost?

$417

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $417 for this service. The price depends on where it is billed: about $398 from a physician practice, and about $513 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$398$331 to $490
FacilityA hospital or hospital-owned outpatient department$513$363 to $575

How much rates vary

Facilitymedian $513 · 10th to 90th $269 to $933Professionalmedian $398 · 10th to 90th $200 to $631
$200$500$1K$2Kfacility $513professional $398

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
Aetna
Setting
Professional
Modifier
None
Typical Low
$338.84
Median
$338.84
Typical High
$363.08
Cigna
Setting
Facility
Modifier
None
Typical Low
$245.47
Median
$245.47
Typical High
$446.68
Cigna
Setting
Professional
Modifier
None
Typical Low
$436.52
Median
$575.44
Typical High
$724.44
Medica
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$575.44
Typical High
$933.25
Medica
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$281.84
Typical High
$2,511.89
Midlands
Setting
Professional
Modifier
None
Typical Low
$436.52
Median
$436.52
Typical High
$436.52
Midlands
Setting
Facility
Modifier
None
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
Midlands
Setting
Professional
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$891.25
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$426.58
Median
$489.78
Typical High
$575.44
United
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$218.78
Typical High
$346.74
Wellmark
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$398.11

Where South Dakota sits

The same service costs 2.9 times more in Montana than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 8th of 51

$417

MT $513DE $178

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.