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Arizona rates for HCPCS 21125

Augmentation, mandibular body or angle; prosthetic material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $4,521.00 / $9,112.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.77 / $2,286.89 / $4,167.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,310.70 / $4,934.39 / $8,070.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$803.18 / $2,069.63 / $3,386.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.77 / $2,198.31 / $4,868.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$647.13 / $2,381.00 / $4,642.39
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,507.58 / $3,379.94 / $19,122.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,149.00 / $3,533.00 / $5,546.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,449.84 / $2,975.29 / $5,353.34