go back

South Dakota rates for HCPCS 21049

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

Professionalmedian $1,514 · 10th–90th $1,122–$3,3110%20%10th90th$1,514$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
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,148.15 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,691.53 / $3,311.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $2,187.76 / $10,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,754.23 / $2,754.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,691.53
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,949.84 / $2,238.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,089.30 / $3,311.31
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,754.23 / $2,754.23