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South Dakota rates for HCPCS L3730

Elbow orthosis (EO), double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated

Facilitymedian $871 · 10th–90th $692–$1,3180%20%10th90th$871Professionalmedian $776 · 10th–90th $550–$1,4130%10%20%10th90th$776$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
$691.83 / $691.83 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $691.83 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,445.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,071.52 / $1,862.09
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $707.95 / $6,606.93
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,288.25 / $1,288.25
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,778.28
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,000.00 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $707.95 / $1,174.90
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02