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Custom Appliance After Lower Jaw Removal

South Dakota rates for HCPCS 21081

Takes impressions of the mouth and builds a custom-made appliance for someone who has had part of the lower jaw removed. The device supports the remaining jaw in a workable position and helps restore chewing, speech, and the shape of the lower face. It is made individually in a dental laboratory and fitted and adjusted over a series of visits.

Rates data updated July 2026.

How much does Custom Appliance After Lower Jaw Removal cost?

$2,570

Typical physician fee. In South Dakota, July 2026.

Insurers have agreed to pay about $2,570 for this service. Most negotiated rates run $1,549 to $3,162.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $2,570 · 10th to 90th $1,202 to $3,715
$1K$2K$5K$10Kprofessional $2,570

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,548.82
Typical High
$3,162.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,398.83
Median
$3,548.13
Typical High
$4,570.88
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,548.82
Median
$3,715.35
Typical High
$11,481.54
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$3,162.28
Typical High
$3,890.45
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$3,162.28
Typical High
$3,890.45
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,862.09
Median
$2,454.71
Typical High
$3,019.95
United
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$2,454.71
Typical High
$4,265.80
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$2,238.72
Median
$2,691.53
Typical High
$4,073.80

Where South Dakota sits

The same service costs 2.7 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 6th of 51

$2,570

AK $3,802KY $1,413

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.