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Massachusetts 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 / $1,179.53 / $1,838.79
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,167.41 / $2,101.34 / $9,976.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.52 / $2,077.32 / $3,378.67
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,315.62 / $1,593.65 / $2,160.12
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,423.36 / $2,821.67 / $3,722.23
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,314.55 / $2,236.52 / $9,976.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,239.76 / $1,859.16 / $3,880.57