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Nonstandard Size or Width

South Dakota rates for HCPCS L3254

Nonstandard size or width

Rates data updated July 2026.

How much does Nonstandard Size or Width cost?

$14.13

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $14.13 for this service. The price depends on where it is billed: about $14.13 from a physician practice, and about $23.99 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$14.13$14.13 to $17.78
FacilityA hospital or hospital-owned outpatient department$23.99$19.95 to $30.20

How much rates vary

Facilitymedian $24 · 10th to 90th $14 to $49Professionalmedian $14 · 10th to 90th $14 to $18
$10$20$50$100facility $24professional $14

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$14.45
Median
$14.45
Typical High
$14.45
Aetna
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$14.13
Typical High
$17.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$7.76
Typical High
$53.70
Medica
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$25.12
Typical High
$60.26
Medica
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$56.23
Midlands
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$53.70
Midlands
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$53.70
United
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$46.77

Where South Dakota sits

The same service costs 9.8 times more in Kansas than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 48th of 51

$14.13

KS $138AL $14.13

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.