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South Dakota rates for HCPCS 21150

Rcnstj Midface Lefort Ii Anterior Intrusion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,643.07 / $1,643.07 / $1,643.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,374.54 / $1,643.07 / $3,874.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,819.53 / $3,670.34 / $4,587.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,073.71 / $2,720.80 / $4,455.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,675.55 / $3,580.98 / $16,240.27
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,035.99 / $4,238.35 / $8,689.45
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,643.61 / $3,583.67 / $4,391.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,062.01 / $2,793.88 / $3,185.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,875.75 / $2,927.34 / $4,553.64
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,160.00 / $3,866.30 / $3,866.30