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South Dakota rates for HCPCS L3761

Elbow orthosis (EO), with adjustable position locking joint(s), prefabricated, off-the-shelf

Facilitymedian $407 · 10th–90th $380–$6760%20%40%10th90th$407Professionalmedian $380 · 10th–90th $245–$7410%20%10th90th$380$200.0$500.0$1.0K$2.0K

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
$380.19 / $380.19 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $380.19 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $616.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $794.33
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $549.54 / $1,047.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $398.11 / $2,754.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $602.56 / $602.56
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $549.54 / $741.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $398.11 / $645.65
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86