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South Dakota rates for HCPCS L3984

Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment

Facilitymedian $275 · 10th–90th $263$5010%50%10th90th$275Professionalmedian $295 · 10th–90th $178$5010%10%10th90th$295$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $275.42 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $269.15 / $363.08
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $549.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $436.52 / $812.83
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $288.40 / $2,454.71
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $501.19 / $501.19
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $776.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $436.52 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $288.40 / $446.68
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52