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South Dakota rates for HCPCS 21087

Impression and custom preparation; nasal prosthesis

Facilitymedian $1,820 · 10th–90th $1,288–$4,0740%10%20%10th90th$1,820Professionalmedian $2,042 · 10th–90th $1,288–$3,7150%10%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,380.38 / $1,584.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,584.89 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,715.35 / $4,677.35
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,511.89 / $4,168.69
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $3,981.07 / $11,748.98
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,388.44 / $4,073.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,388.44 / $4,073.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,630.27 / $3,235.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,630.27 / $4,466.84
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,090.30 / $3,801.89