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Connecticut 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
$2,691.53 / $4,897.79 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,348.96 / $3,715.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $13,803.84 / $16,595.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $2,398.83 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $741.31 / $7,943.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,238.72 / $3,388.44
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,862.09 / $2,344.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $10,232.93 / $16,218.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,819.70 / $3,467.37