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Complex Open Repair of an Upper Jaw Fracture

South Dakota rates for HCPCS 21423

A surgery performed through an open incision to repair a fracture across the upper jaw, at the level where it separates the tooth-bearing bone from the rest of the face, in a case that is more complicated than usual, such as a fracture with many bone fragments or one that involves nerve pathways through the bone. The surgeon directly accesses and realigns the broken bone. It is used for a more complex version of this specific level of midface fracture rather than a straightforward break.

Rates data updated July 2026.

How much does Complex Open Repair of an Upper Jaw Fracture cost?

$2,729

Typical total for the visit. In South Dakota, July 2026.

Insurers have agreed to pay about $2,729 for this procedure. That total is two separate charges: $1,380 to the doctor who performs it, and $1,349 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,380$813 to $1,778
Facility feeThe hospital or surgery center$1,349$1,148 to $2,089

How much rates vary

Facilitymedian $1,349 · 10th to 90th $955 to $4,365Professionalmedian $1,380 · 10th to 90th $661 to $2,291
$1K$2K$5K$10Kfacility $1,349professional $1,380

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$4,365.16
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$794.33
Typical High
$1,621.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$1,819.70
Typical High
$2,290.87
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,288.25
Typical High
$2,041.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,445.44
Typical High
$6,606.93
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,778.28
Typical High
$1,778.28
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,737.80
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,318.26
Typical High
$1,548.82
United
Setting
Facility
Modifier
Global
Typical Low
$4,466.84
Median
$4,466.84
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,412.54
Typical High
$2,137.96
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$1,548.82
Typical High
$1,862.09

Where South Dakota sits

The same service costs 9.9 times more in Indiana than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

South Dakota· 43rd of 50

$2,729

$1,380 physician + $1,349 facility

IN $15,967WV $1,608

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.