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South Dakota rates for HCPCS 21194

Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; with bone graft (includes obtaining graft)

Facilitymedian $2,239 · 10th–90th $1,445–$4,3650%20%10th90th$2,239Professionalmedian $1,820 · 10th–90th $1,318–$3,7150%10%10th90th$1,820$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
$1,445.44 / $1,445.44 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,445.44 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,311.31 / $4,168.69
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,344.23 / $3,890.45
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,691.53 / $16,982.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,388.44 / $3,388.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $3,235.94
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,454.71 / $2,754.23
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
$1,348.96 / $2,344.23 / $4,073.80
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,388.44 / $3,388.44