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South Dakota rates for HCPCS 21485

Closed treatment of temporomandibular dislocation; complicated (eg, recurrent requiring intermaxillary fixation or splinting), initial or subsequent

Facilitymedian $1,202 · 10th–90th $832–$3,1620%10%10th90th$1,202Professionalmedian $1,047 · 10th–90th $741–$2,1380%10%10th90th$1,047$500.0$1.0K$2.0K$5.0K

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
$831.76 / $1,023.29 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $912.01 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,290.87 / $2,818.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,318.26 / $1,819.70
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,621.81 / $7,079.46
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,548.82 / $1,905.46
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,318.26 / $1,584.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,412.54 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,258.93 / $2,137.96
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,819.70 / $2,238.72