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California 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])

Facilitymedian $7,413 · 10th–90th $2,754$15,8490%5%10%10th90th$7,413Professionalmedian $1,549 · 10th–90th $1,122$4,8980%10%20%10th90th$1,549$50.0$200.0$1.0K$5.0K$20.0K

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
$2,398.83 / $6,456.54 / $16,982.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,380.38 / $5,128.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $8,128.31 / $15,848.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,862.09 / $3,801.89
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $5,128.61 / $10,471.29
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,905.46 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $5,754.40 / $5,754.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,621.81 / $3,388.44
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,230.27 / $1,659.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,318.26 / $3,235.94
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $16,982.44 / $28,840.32
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,232.93 / $10,232.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,584.89 / $2,570.40
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,659.59 / $3,235.94
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,023.29 / $1,348.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $11,748.98 / $25,118.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,348.96 / $2,951.21