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South Dakota rates for HCPCS 42210

Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)

Facilitymedian $1,820 · 10th–90th $1,000–$4,8980%20%10th90th$1,820Professionalmedian $1,148 · 10th–90th $1,000–$2,5120%20%10th90th$1,148$500.0$1.0K$2.0K$5.0K$10.0K

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
$1,000.00 / $4,365.16 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,096.48 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,454.71 / $3,090.30
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,659.59 / $3,019.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,659.59 / $11,481.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,511.89 / $2,511.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,737.80 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,659.59 / $2,884.03
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,570.40 / $2,570.40