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Pennsylvania 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 $3,981 · 10th–90th $1,175–$8,5110%10%10th90th$3,981Professionalmedian $1,288 · 10th–90th $1,122–$2,1380%20%40%10th90th$1,288$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$1,174.90 / $3,981.07 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,288.25 / $1,995.26
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $10,000.00 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,513.56 / $2,511.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,698.24 / $2,187.76
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,445.44 / $2,238.72
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31,622.78 / $31,622.78 / $31,622.78
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $2,570.40 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,288.25 / $3,019.95
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,905.46 / $2,818.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,202.26 / $1,288.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,202.26 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $5,754.40 / $19,054.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,445.44 / $2,570.40