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Delaware rates for HCPCS 21125

Augmentation, mandibular body or angle; prosthetic material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,244.36 / $7,244.36 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $2,089.30 / $4,168.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $1,445.44 / $4,897.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,479.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,584.89 / $4,168.69