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Missouri 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
$1,273.32 / $3,214.00 / $7,365.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,025.86 / $1,227.67 / $3,710.75
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,184.58 / $1,525.43 / $2,442.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,211.81 / $1,708.07 / $2,792.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,128.46 / $1,885.82 / $16,394.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,247.64 / $1,793.27 / $9,976.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,156.00 / $4,000.00 / $10,781.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,193.66 / $1,592.91 / $2,612.94