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South Dakota rates for HCPCS L3201

Orthopedic shoe, Oxford with supinator or pronator, infant

Facilitymedian $32 · 10th–90th $26–$680%20%10th90th$32Professionalmedian $32 · 10th–90th $19–$500%10%10th90th$32$20.0$50.0$100.0$200.0

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
$25.70 / $25.70 / $25.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $25.70 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $40.74 / $50.12
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $41.69 / $95.50
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $33.88 / $251.19
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $57.54 / $75.86
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $33.88 / $45.71
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71