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South Dakota rates for HCPCS 21248

Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$672.79 / $839.17 / $2,325.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,655.02 / $2,276.53 / $2,845.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,123.65 / $2,468.34 / $10,316.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,689.89 / $2,105.33 / $2,610.78
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,156.00 / $1,561.62 / $1,921.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,213.75 / $1,860.23 / $2,893.69
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,549.20 / $1,895.50 / $2,332.80