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South Dakota rates for HCPCS L3253

Foot, molded shoe, Plastazote (or similar), custom fitted, each

Facilitymedian $28 · 10th–90th $22–$580%20%40%10th90th$28Professionalmedian $27 · 10th–90th $16–$430%10%20%10th90th$27$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
$21.88 / $21.88 / $21.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $21.88 / $30.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $39.81 / $42.66
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $35.48 / $81.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $28.84 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $48.98 / $63.10
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $28.84 / $38.90
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78