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Alaska rates for HCPCS 21049

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,094.72 / $3,413.04 / $5,788.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,020.88 / $4,056.22 / $4,934.08
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,810.10 / $3,372.12 / $6,845.75
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,332.50 / $5,966.68 / $7,000.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,765.49 / $5,666.10 / $7,552.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,212.70 / $4,895.39 / $7,138.96