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Wisconsin 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 $10,233 · 10th–90th $3,162–$16,9820%5%10%10th90th$10,233Professionalmedian $1,820 · 10th–90th $1,148–$5,6230%20%10th90th$1,820$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
$1,202.26 / $2,511.89 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,230.27 / $3,019.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,511.89 / $6,456.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,715.35 / $6,025.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $4,897.79 / $5,623.41
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,570.40 / $7,244.36
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,951.21 / $3,801.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,630.27 / $15,135.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,398.83 / $10,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $3,090.30 / $5,370.32
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,570.40 / $3,890.45
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $11,220.18 / $16,595.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $6,165.95 / $10,000.00
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $4,073.80
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $7,079.46 / $7,943.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,949.84 / $5,128.61