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South Dakota rates for HCPCS L3930

Hand-finger orthosis (HFO), includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.59 / $69.59 / $69.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.96 / $59.35 / $69.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.85 / $53.85 / $122.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.25 / $116.25 / $145.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.03 / $99.56 / $456.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.33 / $54.93 / $121.82
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.60 / $122.18 / $165.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.64 / $123.99 / $249.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.88 / $84.16 / $100.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.65 / $50.16 / $85.89
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.52 / $105.52 / $105.52