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South Dakota rates for HCPCS 21049

Exc B9 Tum/Cst Maxl Xtr-Oral Osteot&Prtl Maxlc

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.35 / $1,153.41 / $2,739.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,008.57 / $2,614.66 / $3,268.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,195.68 / $2,494.92 / $9,976.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,848.66 / $2,503.90 / $3,172.81
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,329.63 / $1,971.72 / $2,247.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,195.68 / $2,145.11 / $3,336.84
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,230.10 / $2,728.60 / $2,728.60