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South Dakota rates for HCPCS L3740

Elbow orthosis (EO), double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated

Facilitymedian $1,000 · 10th–90th $813–$1,5140%20%40%10th90th$1,000Professionalmedian $851 · 10th–90th $708–$1,6980%20%10th90th$851$500.0$1.0K$2.0K$5.0K$10.0K

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
$812.83 / $812.83 / $812.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $812.83 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,698.24
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,202.26 / $2,187.76
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $851.14 / $10,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,380.38 / $1,380.38
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $2,089.30
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,174.90 / $1,548.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $851.14 / $1,380.38
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26