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South Dakota rates for HCPCS 21193

Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graft

Facilitymedian $2,089 · 10th–90th $1,259–$4,8980%20%10th90th$2,089Professionalmedian $1,585 · 10th–90th $1,122–$3,2360%10%10th90th$1,585$1.0K$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
$1,258.93 / $4,365.16 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,258.93 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,884.03 / $3,630.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,041.74 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $2,238.72 / $14,791.08
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,951.21 / $2,951.21
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,630.27
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,041.74 / $2,398.83
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
$1,202.26 / $2,187.76 / $3,388.44
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,884.03 / $2,884.03