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South Dakota rates for HCPCS 21390

Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant

Facilitymedian $1,349 · 10th–90th $813–$6,9180%20%10th90th$1,349Professionalmedian $1,349 · 10th–90th $871–$1,7380%20%10th90th$1,349$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
$812.83 / $4,365.16 / $6,918.31
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,348.96 / $2,041.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,862.09 / $1,862.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,318.26 / $1,548.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $12,022.64