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Arkansas rates for HCPCS 21125

Augmentation, mandibular body or angle; prosthetic material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$938.09 / $2,333.00 / $4,825.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$649.38 / $2,331.91 / $3,641.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,430.62 / $5,430.62 / $6,516.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.75 / $1,055.51 / $3,581.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,519.08 / $2,519.08 / $2,519.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$884.94 / $1,308.52 / $4,694.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$980.00 / $2,052.00 / $7,058.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,350.91 / $3,580.95 / $5,268.41