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South Dakota rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Facilitymedian $813 · 10th–90th $813–$8130%50%100%$813Professionalmedian $479 · 10th–90th $479–$4790%50%100%$479$500.0

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
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83