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North Dakota rates for HCPCS 21125

Augmentation, mandibular body or angle; prosthetic material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$700.55 / $2,902.37 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$674.77 / $2,497.69 / $3,043.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,339.38 / $1,733.39 / $6,421.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,001.74 / $2,197.26 / $8,129.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$700.55 / $1,190.94 / $4,487.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,919.29 / $5,864.99 / $9,616.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,025.00 / $5,025.00 / $5,025.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,919.29 / $5,539.16 / $6,516.66