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South Dakota rates for HCPCS 21154

Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); without LeFort I

Facilitymedian $3,090 · 10th–90th $1,950–$4,4670%20%10th90th$3,090Professionalmedian $2,455 · 10th–90th $1,778–$4,7860%20%10th90th$2,455$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
$1,949.84 / $1,949.84 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,949.84 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,466.84 / $5,495.41
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,235.94 / $4,897.79
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,467.37 / $19,498.45
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,466.84 / $4,466.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $4,168.69
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,235.94 / $3,801.89
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
$1,995.26 / $3,467.37 / $5,370.32
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,570.88 / $4,570.88