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South Dakota rates for HCPCS L3675

Shoulder orthosis (SO), vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf

Facilitymedian $141 · 10th–90th $132–$2400%20%40%10th90th$141Professionalmedian $141 · 10th–90th $85–$2570%20%10th90th$141$100.0$200.0$500.0$1.0K

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
$131.83 / $131.83 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $131.83 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $281.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $190.55 / $363.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $128.82 / $977.24
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $208.93 / $208.93
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $346.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $194.98 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $131.83 / $213.80
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97