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South Dakota rates for HCPCS 21720

Division of sternocleidomastoid for torticollis, open operation; without cast application

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$513.01 / $513.01 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$403.93 / $513.01 / $1,037.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.14 / $1,171.77 / $1,464.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$622.75 / $824.08 / $1,259.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.00 / $982.00 / $3,855.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$784.26 / $1,275.22 / $3,711.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.00 / $983.93 / $1,420.70
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.50 / $815.83 / $1,067.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.38 / $886.97 / $1,379.73
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,058.90 / $1,295.59 / $1,295.59