go back

South Dakota rates for HCPCS L3960

Shoulder-elbow-wrist-hand orthosis (SEWHO), abduction positioning, airplane design, prefabricated, includes fitting and adjustment

Facilitymedian $741 · 10th–90th $603–$1,0470%20%40%10th90th$741Professionalmedian $603 · 10th–90th $437–$1,0720%20%10th90th$603$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $602.56 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $562.34 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,258.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $831.76 / $1,513.56
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $575.44 / $5,128.61
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $977.24 / $977.24
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,445.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $812.83 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $602.56 / $977.24
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14