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South Dakota rates for HCPCS 21256

Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)

Facilitymedian $1,905 · 10th–90th $1,230–$4,3650%20%10th90th$1,905Professionalmedian $1,585 · 10th–90th $1,148–$3,5480%20%10th90th$1,585$1.0K$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
$1,230.27 / $1,230.27 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,230.27 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,818.38 / $3,548.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,041.74 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $2,238.72 / $14,791.08
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,818.38 / $2,818.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $2,691.53
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,041.74 / $2,454.71
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
$1,096.48 / $2,089.30 / $3,467.37
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,951.21 / $2,951.21