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South Dakota rates for HCPCS 21406

Open treatment of fracture of orbit, except blowout; without implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $588.84 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $588.84 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,348.96 / $1,698.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $954.99 / $1,513.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $954.99 / $5,011.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,318.26 / $1,318.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,258.93
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $977.24 / $1,148.15
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
$616.60 / $1,047.13 / $1,621.81
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,348.96 / $1,412.54