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South Dakota rates for HCPCS 21199

Osteotomy Mandible Sgmtl W/Genioglossus Advmnt

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,026.55 / $1,026.55 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$856.73 / $1,026.55 / $2,412.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.14 / $2,314.71 / $2,893.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,359.42 / $1,690.19 / $2,668.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$970.08 / $2,087.17 / $13,778.46
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,897.36 / $2,689.94 / $6,855.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,549.40 / $2,150.50 / $2,722.65
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,242.97 / $1,683.24 / $1,980.16
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
$1,093.28 / $2,017.88 / $2,920.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,964.40 / $2,403.50 / $2,403.50