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South Dakota rates for HCPCS L3995

Addition to upper extremity orthosis, sock, fracture or equal, each

Facilitymedian $34 · 10th–90th $30–$490%20%10th90th$34Professionalmedian $30 · 10th–90th $18–$520%10%10th90th$30$20.0$50.0$100.0$200.0

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
$25.70 / $30.90 / $30.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $23.99 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $40.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $64.57
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $38.02 / $67.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $25.70 / $234.42
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $39.81 / $39.81
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $40.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $64.57
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $36.31 / $47.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $27.54 / $50.12
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88