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South Dakota rates for HCPCS 21275

Secondary revision of orbitocraniofacial reconstruction

Facilitymedian $1,413 · 10th–90th $832–$6,9180%20%10th90th$1,413Professionalmedian $1,072 · 10th–90th $776–$2,4550%10%10th90th$1,072$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
$831.76 / $4,365.16 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $831.76 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,949.84 / $2,454.71
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,380.38 / $2,137.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,513.56 / $14,791.08
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,905.46 / $1,905.46
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,862.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,412.54 / $1,659.59
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
$758.58 / $1,445.44 / $2,344.23
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,995.26 / $1,995.26