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South Dakota rates for HCPCS 21172

Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)

Facilitymedian $3,311 · 10th–90th $1,995–$4,8980%20%10th90th$3,311Professionalmedian $2,630 · 10th–90th $1,950–$5,0120%10%10th90th$2,630$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
$1,995.26 / $4,365.16 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,995.26 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,570.88 / $5,623.41
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,235.94 / $4,570.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,548.13 / $15,135.61
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $4,466.84 / $4,466.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $4,265.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,388.44 / $4,168.69
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
$1,862.09 / $3,388.44 / $5,370.32
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $5,011.87 / $5,011.87