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South Dakota rates for HCPCS L4130

Replace pretibial shell

Facilitymedian $490 · 10th–90th $398–$7940%20%40%10th90th$490Professionalmedian $501 · 10th–90th $288–$8320%10%20%10th90th$501$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
$398.11 / $398.11 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $398.11 / $645.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $831.76
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $645.65 / $1,202.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $426.58 / $3,715.35
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $676.08 / $676.08
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $1,148.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $645.65 / $851.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $426.58 / $660.69
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84