go back

Wisconsin rates for HCPCS 21120

Genioplasty Augmentation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$499.84 / $1,041.08 / $13,367.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$499.84 / $656.86 / $2,562.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,479.00 / $9,096.00 / $15,579.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.63 / $1,153.47 / $3,226.44
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,995.29 / $5,995.29 / $5,995.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,768.90 / $2,067.10 / $3,170.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$752.06 / $1,817.16 / $3,025.01
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$499.84 / $753.15 / $1,356.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$517.71 / $917.29 / $7,160.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.64 / $1,456.90 / $4,891.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.47 / $396.79 / $1,272.21
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$499.84 / $749.76 / $1,356.59
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,143.52 / $1,565.77 / $2,231.54
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,580.50 / $3,580.50 / $5,994.41
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,087.38 / $2,802.24 / $4,891.20
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,657.66 / $1,657.66 / $2,184.39
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,610.58 / $3,233.02 / $4,236.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,103.00 / $6,477.00 / $8,384.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$687.20 / $1,320.92 / $2,891.26