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Rhode Island 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
$2,090.73 / $2,778.87 / $3,955.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,131.17 / $1,550.00 / $1,976.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,046.93 / $1,449.04 / $2,525.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,509.42 / $2,099.67 / $2,632.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,219.00 / $7,228.00 / $12,680.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,046.85 / $1,793.02 / $2,813.71