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South Dakota rates for HCPCS 21125

Augmentation, mandibular body or angle; prosthetic material

Facilitymedian $2,754 · 10th–90th $676–$6,9180%10%10th90th$2,754Professionalmedian $2,512 · 10th–90th $676–$5,4950%10%10th90th$2,512$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
$676.08 / $2,754.23 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $2,238.72 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,995.26 / $7,762.47
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,949.84 / $6,165.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $6,606.93 / $19,054.61
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,698.24 / $6,606.93
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,621.81 / $7,244.36
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $3,548.13 / $5,248.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $2,238.72 / $7,762.47
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,584.89 / $6,025.60