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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
$1,445.44 / $7,244.36 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $776.25 / $1,778.28
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $7,585.78 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,230.27 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $870.96 / $1,479.11
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,122.02 / $1,445.44
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $933.25 / $1,949.84
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $12,589.25 / $12,589.25
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $5,495.41 / $10,964.78
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $977.24 / $2,187.76
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $794.33 / $1,548.82
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,000.00 / $1,479.11
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $741.31 / $1,096.48
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $776.25 / $1,096.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $3,548.13 / $18,197.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $851.14 / $1,445.44