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Louisiana 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
$580.00 / $1,570.20 / $3,685.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,141.32 / $1,582.66 / $2,220.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,783.10 / $8,674.20 / $11,969.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,322.88 / $1,593.80 / $2,374.07
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $1,056.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$725.00 / $725.00 / $725.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,166.28 / $1,691.79 / $2,385.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,141.00 / $4,717.00 / $11,696.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,127.34 / $1,439.75 / $2,427.53