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South Dakota rates for HCPCS L4392

Replacement, soft interface material, static AFO

Facilitymedian $22 · 10th–90th $19–$350%20%40%10th90th$22Professionalmedian $20 · 10th–90th $12–$420%20%10th90th$20$10.0$20.0$50.0$100.0

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
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $19.05 / $22.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $41.69
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.38 / $27.54 / $52.48
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $18.62 / $141.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $29.51 / $30.20
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $50.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $28.18 / $37.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $19.50 / $31.62
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70