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Nebraska 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
$4,241.22 / $11,611.47 / $24,068.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.39 / $793.39 / $4,157.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,522.85 / $8,579.33 / $16,595.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.26 / $1,291.05 / $1,725.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,091.67 / $2,091.67 / $2,091.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,354.00 / $1,936.84 / $2,627.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$793.39 / $1,388.43 / $5,402.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,090.58 / $1,803.66 / $2,476.01
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,578.37 / $2,091.67 / $2,656.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,373.92 / $1,798.02 / $2,627.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,711.00 / $5,356.00 / $7,772.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,090.58 / $1,838.88 / $2,348.94