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Connecticut rates for HCPCS 21125

Augmentation, mandibular body or angle; prosthetic material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,090.00 / $7,687.65 / $15,171.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$649.38 / $2,286.89 / $4,887.85
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,920.00 / $11,936.00 / $15,915.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$694.46 / $1,617.74 / $2,742.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,644.00 / $10,131.29 / $10,131.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,098.52 / $3,033.89 / $6,550.86
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,296.00 / $4,588.00 / $4,682.00
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,188.19 / $4,102.93 / $5,074.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,565.00 / $6,647.00 / $9,973.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,534.15 / $4,593.02 / $8,151.89