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South Dakota rates for HCPCS L4397

Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf

Facilitymedian $145 · 10th–90th $141–$2450%20%40%10th90th$145Professionalmedian $141 · 10th–90th $89–$2630%10%10th90th$141$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $138.04 / $169.82
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $295.12
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $194.98 / $380.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $141.25 / $1,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $213.80 / $213.80
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $363.08
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $199.53 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $141.25 / $239.88
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21