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Maryland rates for HCPCS 21025

Excision Bone Mandible

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.26 / $64.26 / $64.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.64 / $777.56 / $2,088.73
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.54 / $827.57 / $910.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$445.00 / $453.73 / $2,754.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$666.52 / $1,027.53 / $1,969.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.81 / $1,078.19 / $1,426.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.00 / $847.00 / $1,560.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$682.82 / $1,044.13 / $1,934.43
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.49 / $961.18 / $1,192.73