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South Dakota rates for HCPCS L3650

Shoulder orthosis (SO), figure of eight design abduction restrainer, prefabricated, off-the-shelf

Facilitymedian $54 · 10th–90th $47–$890%20%40%10th90th$54Professionalmedian $54 · 10th–90th $32–$910%10%10th90th$54$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
$46.77 / $53.70 / $53.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $46.77 / $61.66
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $114.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $70.79 / $123.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $50.12 / $426.58
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $85.11 / $85.11
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $117.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $66.07 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $50.12 / $89.13
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13