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South Dakota rates for HCPCS 21116

Injection procedure for temporomandibular joint arthrography

Facilitymedian $229 · 10th–90th $44–$2,2910%10%10th90th$229Professionalmedian $182 · 10th–90th $41–$4270%5%10%10th90th$182$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$43.65 / $229.09 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $181.97 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $295.12 / $630.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $213.80 / $446.68
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $295.12 / $794.33
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $295.12 / $524.81
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $295.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $218.78 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $128.82 / $457.09
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $104.71 / $489.78