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Michigan 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 / $1,240.75 / $1,527.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.10 / $1,730.49 / $2,985.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$858.36 / $1,420.65 / $2,590.17
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,136.50 / $1,298.85 / $1,907.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.47 / $764.38 / $1,292.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,225.96 / $1,476.66 / $1,993.99