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South Dakota rates for HCPCS L3674

Shoulder orthosis (SO), abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $977 · 10th–90th $891–$1,6220%20%40%10th90th$977Professionalmedian $912 · 10th–90th $575–$1,8620%20%10th90th$912$500.0$1.0K$2.0K$5.0K

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
$891.25 / $891.25 / $891.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $891.25 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $1,862.09
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,288.25 / $2,454.71
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $912.01 / $6,456.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,412.54 / $1,412.54
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $2,344.23
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,318.26 / $1,737.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $912.01 / $1,513.56
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27