go back

Pennsylvania rates for HCPCS 21122

Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,278.00 / $4,250.00 / $10,398.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.59 / $733.02 / $1,004.46
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$739.38 / $767.28 / $1,437.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$839.94 / $839.94 / $839.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.08 / $878.31 / $1,499.34
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$879.21 / $1,184.74 / $1,518.63
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,916.44 / $10,916.44 / $17,224.72
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,426.00 / $5,350.00 / $11,083.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.59 / $783.67 / $4,083.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.00 / $724.00 / $1,552.40
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$839.94 / $839.94 / $839.94
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$671.94 / $884.91 / $1,499.34
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$729.09 / $729.09 / $737.42
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$710.52 / $729.09 / $777.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$646.26 / $885.21 / $1,540.65