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South Dakota rates for HCPCS 21031

Excision of torus mandibularis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $380.19 / $616.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $812.83 / $1,148.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $794.33 / $2,884.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $660.69 / $891.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $660.69 / $891.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $588.84 / $741.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $588.84 / $1,047.13
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $645.65 / $891.25