go back

Ankle-Foot Orthosis, Prefabricated

South Dakota rates for HCPCS L1930

Ankle-foot orthosis (AFO), plastic or other material, prefabricated, includes fitting and adjustment

Rates data updated July 2026.

Facilitymedian $282 · 10th–90th $200$3980%10%20%10th90th$282Professionalmedian $251 · 10th–90th $158$4370%10%20%10th90th$251$100.0$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
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$199.53
Typical High
$275.42
Avera
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$309.03
Typical High
$323.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$436.52
Medica
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$288.40
Typical High
$549.54
Medica
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$204.17
Typical High
$1,862.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$338.84
Typical High
$338.84
Midlands
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Midlands
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$524.81
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$288.40
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$154.88
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$204.17
Typical High
$354.81
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03