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Utah 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
$1,221.53 / $4,387.00 / $9,932.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$786.44 / $1,221.53 / $4,689.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.16 / $1,200.32 / $1,818.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.32 / $500.92 / $775.53
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,525.68 / $6,104.56 / $8,896.10
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,100.06 / $1,457.82 / $1,967.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$871.00 / $4,455.00 / $7,048.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$747.40 / $905.76 / $1,459.27