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Elbow Orthosis (EO), Double Upright Free Motion

South Dakota rates for HCPCS L3720

Elbow orthosis (EO), double upright with forearm/arm cuffs, free motion, custom fabricated

Rates data updated October 2026.

How much does Elbow Orthosis (EO), Double Upright Free Motion cost?

$724

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $724 for this service. The price depends on where it is billed: about $724 from a physician practice, and about $832 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$724$479 to $832
FacilityA hospital or hospital-owned outpatient department$832$692 to $851

How much rates vary

Facilitymedian $832 · 10th to 90th $513 to $1,349Professionalmedian $724 · 10th to 90th $324 to $955
$500$1K$2K$5Kfacility $832professional $724

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$524.81
Median
$524.81
Typical High
$524.81
Aetna
Setting
Professional
Modifier
None
Typical Low
$489.78
Median
$489.78
Typical High
$524.81
Cigna
Setting
Facility
Modifier
None
Typical Low
$446.68
Median
$446.68
Typical High
$851.14
Cigna
Setting
Professional
Modifier
None
Typical Low
$831.76
Median
$870.96
Typical High
$1,096.48
Medica
Setting
Facility
Modifier
None
Typical Low
$512.86
Median
$831.76
Typical High
$1,348.96
Medica
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$457.09
Typical High
$6,165.95
Midlands
Setting
Professional
Modifier
None
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
Midlands
Setting
Facility
Modifier
None
Typical Low
$851.14
Median
$851.14
Typical High
$851.14
Midlands
Setting
Professional
Modifier
None
Typical Low
$691.83
Median
$691.83
Typical High
$1,288.25
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$616.60
Median
$724.44
Typical High
$831.76
United
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$398.11
Typical High
$602.56
Wellmark
Setting
Professional
Modifier
None
Typical Low
$724.44
Median
$724.44
Typical High
$724.44

Where South Dakota sits

The same service costs 4.6 times more in Hawaii than in Delaware. 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· 8th of 51

$724

HI $1,514DE $331

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.