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South Dakota rates for HCPCS L4360

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Facilitymedian $52 · 10th–90th $52–$3390%50%90th$52Professionalmedian $275 · 10th–90th $138–$4170%10%10th90th$275$100.0$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
$52.48 / $52.48 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $229.09 / $363.08
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $457.09
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $323.59 / $630.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $223.87 / $2,041.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $338.84 / $346.74
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $602.56
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $338.84 / $446.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $223.87 / $363.08
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12