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Michigan rates for HCPCS 21123

Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,070.44 / $4,933.00 / $6,853.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$773.52 / $963.08 / $1,111.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,436.15 / $2,859.32 / $3,873.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.52 / $749.25 / $1,388.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.11 / $964.42 / $1,910.80
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.95 / $4,933.00 / $6,853.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$829.42 / $915.14 / $1,388.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.50 / $583.13 / $954.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,450.00 / $5,048.00 / $7,355.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$862.61 / $1,033.57 / $1,463.20