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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
$933.25 / $1,148.15 / $3,090.30
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,258.93 / $2,089.30
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,445.44 / $1,862.09
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,230.27 / $1,949.84
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,412.54 / $3,090.30
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,348.96 / $2,454.71
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,000.00 / $1,023.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,230.27 / $1,995.26