go back

South Dakota rates for HCPCS L2106

Ankle-foot orthosis (AFO), fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$659.87 / $659.87 / $659.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.19 / $523.63 / $659.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$550.80 / $550.80 / $842.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$976.42 / $1,101.00 / $1,376.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$523.63 / $884.93 / $4,148.45
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.16 / $488.26 / $909.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$700.60 / $842.59 / $1,469.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$690.08 / $854.45 / $1,610.19
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.94 / $748.04 / $889.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.16 / $509.53 / $1,092.14
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.67 / $750.67 / $750.67