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South Dakota rates for HCPCS 21497

Interdental wiring, for condition other than fracture

Facilitymedian $933 · 10th–90th $617–$3,1620%10%10th90th$933Professionalmedian $813 · 10th–90th $562–$1,6600%10%10th90th$813$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
$616.60 / $741.31 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $676.08 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,698.24 / $2,137.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,047.13 / $1,621.81
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,584.89 / $5,248.07
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,318.26 / $1,548.82
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,380.38 / $1,698.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,148.15 / $1,380.38
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
$588.84 / $1,148.15 / $1,862.09
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,380.38 / $1,659.59