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South Dakota rates for HCPCS L3908

Wrist-hand orthosis (WHO), wrist extension control cock-up, nonmolded, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.67 / $28.53 / $55.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.00 / $42.16 / $118.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.70 / $45.96 / $73.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.38 / $93.38 / $116.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.88 / $71.67 / $358.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.46 / $52.63 / $82.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.39 / $73.81 / $126.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.47 / $74.87 / $141.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.09 / $64.50 / $76.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.80 / $38.44 / $54.92
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.75 / $63.75 / $63.75