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California 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])

Professionalmedian $1,445 · 10th–90th $1,072–$4,7860%10%10th90th$1,445$100.0$500.0$2.0K$10.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,288.25 / $5,011.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,819.70 / $3,548.13
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,819.70 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,548.82 / $3,162.28
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $1,148.15 / $1,548.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,258.93 / $2,630.27
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,659.59
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,548.82 / $3,090.30
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $3,890.45
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $954.99 / $1,288.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,288.25 / $2,818.38