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South Dakota rates for HCPCS 21047

Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s])

Facilitymedian $2,042 · 10th–90th $1,230–$4,3650%20%10th90th$2,042Professionalmedian $1,622 · 10th–90th $1,148–$3,5480%10%20%10th90th$1,622$1.0K$2.0K$5.0K$10.0K

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
$1,230.27 / $3,090.30 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,230.27 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,818.38 / $3,548.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,041.74 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $2,398.83 / $10,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,019.95 / $3,019.95
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $2,884.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,089.30 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,187.76 / $3,548.13
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,884.03 / $2,884.03