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South Dakota rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $3,162 · 10th–90th $2,818–$5,6230%20%40%10th90th$3,162Professionalmedian $3,162 · 10th–90th $1,380–$6,1660%10%20%10th90th$3,162$1.0K$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,162.28 / $3,162.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,884.03 / $6,025.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,715.35 / $4,677.35
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $4,786.30 / $6,606.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $4,073.80 / $25,118.86
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $6,606.93 / $6,606.93
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $3,388.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $4,168.69 / $8,128.31
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,230.27 / $1,230.27