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Arizona 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
$1,582.00 / $2,933.00 / $6,483.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,075.74 / $1,191.90 / $2,483.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$587.35 / $2,211.19 / $3,616.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,261.54 / $1,441.76 / $1,802.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,099.56 / $1,534.31 / $2,459.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,162.06 / $1,578.66 / $7,066.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,125.00 / $1,396.49 / $9,976.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,637.00 / $6,477.00 / $9,010.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,109.75 / $1,312.80 / $2,432.12