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South Dakota rates for HCPCS 21461

Open treatment of mandibular fracture; without interdental fixation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,095.58 / $1,927.14 / $1,927.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,309.63 / $2,281.23 / $4,500.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,235.57 / $3,860.24 / $9,092.27
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,508.15 / $2,558.12 / $3,567.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00