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South Dakota rates for HCPCS L4387

Walking boot, nonpneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf

Facilitymedian $148 · 10th–90th $60–$3090%10%20%10th90th$148Professionalmedian $132 · 10th–90th $85–$2750%10%20%10th90th$132$100.0$200.0$500.0$1.0K

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
$60.26 / $131.83 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $131.83 / $218.78
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $204.17 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $275.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $181.97 / $363.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $141.25 / $954.99
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $208.93 / $208.93
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $346.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $194.98 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $134.90 / $223.87
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97