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South Dakota rates for HCPCS L4000

Replace girdle for spinal orthosis (cervical-thoracic-lumbar-sacral orthosis (CTLSO) or spinal orthosis SO)

Facilitymedian $1,175 · 10th–90th $1,096–$1,9950%20%10th90th$1,175Professionalmedian $1,122 · 10th–90th $676–$2,1380%20%10th90th$1,122$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
$1,096.48 / $1,096.48 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,096.48 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $2,290.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,621.81 / $3,019.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,071.52 / $9,120.11
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,737.80 / $1,737.80
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $2,951.21
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,621.81 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $1,096.48 / $1,778.28
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $1,513.56