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South Dakota rates for HCPCS L3904

Wrist-hand-finger orthosis (WHFO), external powered, electric, custom fabricated

Facilitymedian $2,951 · 10th–90th $2,512–$5,2480%20%40%10th90th$2,951Professionalmedian $2,951 · 10th–90th $1,445–$5,3700%10%10th90th$2,951$2.0K$5.0K$10.0K$20.0K

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
$2,570.40 / $2,570.40 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,570.40 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $5,370.32
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $4,073.80 / $8,128.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,570.40 / $25,703.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,548.13 / $3,548.13
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $3,630.78 / $3,630.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $7,762.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $4,265.80 / $5,754.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,570.40 / $4,168.69
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $3,090.30