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Removal Of A Noncancerous Growth From Upper Jaw

Wisconsin rates for HCPCS 21049

Surgery to remove a noncancerous growth or cyst from the upper jaw bone. Because of the size or position of the growth, the surgeon cuts through and removes a section of the jaw bone along with it rather than simply scooping it out.

Rates data updated July 2026.

Professionalmedian $2,344 · 10th–90th $1,148$5,7540%10%10th90th$2,344$50.0$200.0$1.0K$5.0K

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
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,174.90
Typical High
$4,466.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$2,344.23
Typical High
$6,456.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$4,677.35
Typical High
$5,370.32
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$2,041.74
Median
$2,754.23
Typical High
$3,548.13
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$2,238.72
Typical High
$10,000.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$70.79
Network Health
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$2,884.03
Typical High
$5,011.87
Quartz
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$2,454.71
Typical High
$3,548.13
Quartz
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$5,754.40
Typical High
$10,000.00
Security Health
Setting
Professional
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$3,981.07
Security Health
Setting
Professional
Modifier
Global
Typical Low
$3,311.31
Median
$6,606.93
Typical High
$7,413.10
United
Setting
Professional
Modifier
Global
Typical Low
$1,258.93
Median
$1,862.09
Typical High
$4,897.79