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South Dakota rates for HCPCS 21355

Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $457.09 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $426.58 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $954.99 / $1,318.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $660.69 / $1,047.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $891.25 / $3,388.44
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $741.31 / $977.24
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $741.31 / $1,000.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $660.69 / $870.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $676.08 / $1,148.15
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $776.25 / $1,071.52