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South Dakota rates for HCPCS 21247

Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)

Facilitymedian $2,512 · 10th–90th $1,585–$4,3650%20%10th90th$2,512Professionalmedian $2,042 · 10th–90th $1,445–$3,8900%10%10th90th$2,042$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
$1,584.89 / $1,584.89 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,584.89 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,715.35 / $4,570.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,630.27 / $3,981.07
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,884.03 / $12,882.50
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,715.35 / $3,715.35
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $3,388.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,630.27 / $3,090.30
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
$1,548.82 / $2,691.53 / $4,365.16
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,715.35 / $3,715.35