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Colorado 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
$1,213.39 / $4,955.00 / $9,888.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,141.32 / $1,213.39 / $1,785.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,946.00 / $9,472.00 / $17,487.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,264.91 / $1,711.31 / $2,720.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,178.55 / $4,178.55 / $13,162.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,363.67 / $1,736.67 / $2,542.21
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,213.39 / $1,681.93 / $2,159.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,321.52 / $1,742.00 / $2,402.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,251.00 / $11,924.00 / $19,712.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,371.68 / $1,837.50 / $2,864.39