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South Dakota rates for HCPCS 21123

Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)

Facilitymedian $1,445 · 10th–90th $871–$6,9180%20%10th90th$1,445Professionalmedian $1,148 · 10th–90th $794–$2,1380%10%20%10th90th$1,148$1.0K$2.0K$5.0K

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
$870.96 / $4,365.16 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $870.96 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,995.26 / $2,454.71
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,412.54 / $2,089.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,659.59 / $8,511.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,089.30 / $2,089.30
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,995.26
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,380.38 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,479.11 / $2,454.71
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,995.26 / $1,995.26