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South Dakota rates for HCPCS L3765

Elbow-wrist-hand-finger orthosis (EWHFO), rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $977 · 10th–90th $123–$1,6600%20%10th90th$977Professionalmedian $1,023 · 10th–90th $631–$1,8620%20%10th90th$1,023$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $977.24 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $977.24 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $2,041.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,380.38 / $2,691.53
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $954.99 / $7,079.46
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,548.82 / $1,548.82
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,584.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $2,570.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,412.54 / $1,862.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $954.99 / $1,584.89
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26