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South Dakota rates for HCPCS 21137

Reduction Forehead Contouring Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$749.19 / $749.19 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$628.28 / $749.19 / $1,790.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,304.73 / $1,698.44 / $2,123.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$910.56 / $1,234.27 / $1,792.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$709.06 / $1,436.19 / $6,723.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,378.12 / $1,938.82 / $3,276.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,059.54 / $1,506.76 / $2,009.93
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.32 / $1,176.26 / $1,478.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$820.68 / $1,709.75 / $2,082.89
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,466.40 / $1,794.20 / $1,794.20