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South Dakota rates for HCPCS 21048

Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,000.00 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,344.23 / $2,951.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,905.46 / $9,120.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,570.40 / $2,570.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $2,570.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,698.24 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,949.84 / $3,235.94
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,290.87 / $2,344.23