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Removal Of A Noncancerous Growth From Upper Jaw

South Dakota rates for HCPCS 21049

Surgery to remove a noncancerous growth or cyst from the upper jaw bone. Because of the size or position of the growth, the surgeon cuts through and removes a section of the jaw bone along with it rather than simply scooping it out.

Rates data updated July 2026.

Professionalmedian $2,042 · 10th–90th $977$3,3110%10%20%10th90th$2,042$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
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,148.15
Typical High
$2,511.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,344.23
Median
$2,691.53
Typical High
$3,311.31
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$2,187.76
Typical High
$10,000.00
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$2,754.23
Typical High
$2,754.23
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$2,511.89
Typical High
$2,691.53
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,905.46
Typical High
$2,238.72
United
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$2,089.30
Typical High
$3,311.31
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$2,137.96
Median
$2,238.72
Typical High
$2,630.27