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South Dakota rates for HCPCS 21138

Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $3,548.13 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $912.01 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,089.30 / $2,630.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,513.56 / $2,344.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,548.82 / $8,317.64
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,089.30 / $2,089.30
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $1,778.28 / $2,041.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,479.11 / $1,778.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,621.81 / $2,511.89
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,089.30 / $2,187.76