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South Dakota rates for HCPCS 21089

Unlisted Maxillofacial Prosthetic Procedure

Insurance Carrier
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $480.00 / $480.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00