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Pennsylvania 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
$912.26 / $1,030.27 / $1,455.90
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$995.65 / $1,033.22 / $1,033.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$943.58 / $1,271.15 / $2,123.44
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,164.57 / $1,545.36 / $2,011.53
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$938.63 / $1,139.03 / $3,084.84
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,074.70 / $1,074.70 / $2,373.19
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$956.12 / $1,298.10 / $2,155.42
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$939.40 / $969.94 / $1,026.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$935.62 / $1,279.16 / $2,058.85