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South Dakota rates for HCPCS L4040

Replace molded thigh lacer, for custom fabricated orthosis only

Facilitymedian $372 · 10th–90th $347–$5890%20%40%10th90th$372Professionalmedian $398 · 10th–90th $214–$7240%20%10th90th$398$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $346.74 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $724.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $478.63 / $891.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $331.13 / $3,388.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $537.03 / $537.03
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $851.14
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $478.63 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $346.74 / $562.34
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09