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Wisconsin rates for HCPCS 21040

Excision of benign tumor or cyst of mandible, by enucleation and/or curettage

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $758.58 / $3,090.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $467.74 / $1,122.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $4,786.30 / $7,585.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $758.58 / $2,137.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,445.44 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $1,380.38 / $2,187.76
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $645.65 / $3,548.13
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $977.24 / $1,380.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $707.95 / $7,762.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $1,023.29 / $3,467.37
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $549.54
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,096.48 / $1,621.81
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,370.32 / $7,943.28
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $2,398.83 / $3,388.44
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,344.23 / $3,019.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $7,413.10 / $9,120.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $691.83 / $1,862.09