go back

South Dakota rates for HCPCS L2108

Ankle-foot orthosis (AFO), fracture orthosis, tibial fracture cast orthosis, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$962.44 / $962.44 / $962.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.17 / $937.01 / $962.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$752.15 / $752.15 / $1,324.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,605.75 / $1,621.81 / $2,007.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$937.01 / $1,439.08 / $6,344.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.08 / $873.72 / $1,428.63
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,100.95 / $1,324.08 / $2,309.94
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,168.43 / $1,342.71 / $2,530.27
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,143.36 / $1,338.59 / $1,591.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.20 / $683.84 / $1,385.15
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,179.64 / $1,179.64 / $1,179.64