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South Dakota rates for HCPCS 21127

Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $2,818.38 / $6,309.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,290.87 / $11,748.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $8,912.51 / $29,512.09
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,949.84 / $8,912.51
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,995.26 / $10,000.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $5,128.61 / $7,585.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $3,019.95 / $10,964.78
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,862.09 / $9,120.11