go back

South Dakota rates for HCPCS 21100

Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)

Facilitymedian $646 · 10th–90th $363–$4,3650%10%10th90th$646Professionalmedian $676 · 10th–90th $363–$1,4790%5%10%10th90th$676$200.0$500.0$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
$363.08 / $645.65 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $575.44 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,071.52 / $1,862.09
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $831.76 / $1,584.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,698.24 / $4,570.88
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $891.25 / $1,584.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $912.01 / $1,905.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $912.01 / $1,445.44
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
$446.68 / $870.96 / $1,819.70
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $870.96 / $1,479.11