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South Dakota rates for HCPCS 21206

Osteotomy, maxilla, segmental (eg, Wassmund or Schuchard)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $977.24 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,290.87 / $2,884.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $2,041.74 / $10,964.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,691.53 / $2,691.53
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $2,398.83 / $2,691.53
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,659.59 / $2,089.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,041.74 / $3,388.44
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,238.72 / $2,290.87