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South Dakota rates for HCPCS 21030

Exc Benign Tumor/Cyst Maxl/Zygoma Encl & Curtg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.43 / $474.78 / $474.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$368.43 / $474.78 / $749.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$765.35 / $1,052.76 / $1,339.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$521.96 / $725.38 / $1,154.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.85 / $1,162.90 / $3,427.04
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$644.61 / $930.15 / $1,233.06
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$789.47 / $966.80 / $1,233.06
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.49 / $712.88 / $898.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.61 / $895.12 / $1,392.41
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.20 / $865.30 / $1,090.59