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South Dakota rates for HCPCS L3927

Finger Orthosis Proximal Interphalangeal (Pip)/Distal Interphalangeal (Dip) Without Joint/Spring Extension/Flexion (E.G. Static Or Ring Type) May Include Soft Interface Material Prefabricated Off-The-Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.67 / $26.67 / $26.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.57 / $20.57 / $26.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.80 / $24.80 / $41.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.63 / $44.63 / $55.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.51 / $44.80 / $178.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.45 / $24.72 / $41.87
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.93 / $41.99 / $65.75
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.40 / $42.60 / $80.27
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.35 / $37.86 / $45.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.25 / $25.80 / $40.67
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.26 / $36.26 / $36.26