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Massachusetts 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 $2,884 · 10th–90th $1,230–$6,3100%10%10th90th$2,884Professionalmedian $1,549 · 10th–90th $1,148–$3,2360%10%10th90th$1,549$100.0$500.0$2.0K$10.0K$50.0K

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
$1,230.27 / $2,818.38 / $5,128.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,348.96 / $3,019.95
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $6,165.95 / $28,840.32
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,905.46 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,862.09 / $3,630.78
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,513.56 / $3,467.37
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,479.11 / $2,089.30
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $6,165.95 / $13,182.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $2,089.30 / $3,311.31
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $6,165.95 / $28,840.32
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,905.46 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $5,888.44 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,949.84 / $3,548.13