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South Dakota rates for HCPCS L3976

Shoulder-elbow-wrist-hand-finger orthosis (SEWHO), abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $1,413 · 10th–90th $1,288–$2,2910%20%40%10th90th$1,413Professionalmedian $1,288 · 10th–90th $832–$2,6300%20%10th90th$1,288$1.0K$2.0K$5.0K$10.0K

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
$1,288.25 / $1,288.25 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,258.93 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,691.53
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,819.70 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,230.27 / $9,332.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,995.26 / $1,995.26
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,041.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $3,311.31
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,862.09 / $2,454.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,258.93 / $2,089.30
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80