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Idaho 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
$1,628.00 / $4,500.00 / $7,205.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,141.32 / $1,608.42 / $2,595.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,502.28 / $3,502.28 / $3,512.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,419.40 / $1,911.76 / $2,294.76
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,165.29 / $2,346.19 / $3,140.35
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,953.95 / $2,131.58 / $2,883.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $1,709.03 / $2,150.07
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,660.78 / $14,097.25 / $17,807.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,051.94 / $2,414.06 / $2,883.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $10,120.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,381.67 / $1,917.49 / $2,719.49