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South Dakota rates for HCPCS 21145

Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)

Facilitymedian $2,399 · 10th–90th $1,585–$4,3650%20%10th90th$2,399Professionalmedian $1,995 · 10th–90th $1,413–$3,8020%10%10th90th$1,995$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
$1,584.89 / $1,584.89 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,584.89 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,630.78 / $4,570.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,511.89 / $4,265.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,884.03 / $13,803.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,630.78 / $3,630.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,548.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,630.27 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,570.40 / $4,365.16
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,630.78 / $3,630.78