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Alaska rates for HCPCS 21047

Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s])

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,598.11 / $7,412.70 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,141.32 / $3,598.11 / $6,102.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,176.87 / $4,307.18 / $5,212.70
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,164.01 / $6,102.51 / $8,543.51
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,960.53 / $3,552.63 / $7,212.17
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,576.25 / $6,321.00 / $7,652.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,164.01 / $6,102.51 / $8,543.51
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,854.79 / $5,981.25 / $8,287.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,445.74 / $6,891.48 / $7,580.63