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California rates for HCPCS 21048

Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,202.26 / $5,495.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,584.89 / $3,235.94
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,548.82 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,380.38 / $2,818.38
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $1,071.52 / $1,445.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,122.02 / $2,187.76
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,120.11 / $9,120.11 / $9,120.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,412.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,412.54 / $2,691.53
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,548.13 / $3,548.13
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $758.58 / $977.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,122.02 / $2,344.23