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New Hampshire rates for HCPCS 21125

Augmentation, mandibular body or angle; prosthetic material

Facilitymedian $5,495 · 10th–90th $2,399–$22,3870%10%10th90th$5,495Professionalmedian $1,698 · 10th–90th $759–$5,4950%10%10th90th$1,698$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $5,370.32 / $22,387.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $2,818.38 / $4,897.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,623.41 / $9,120.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,288.25 / $1,819.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $2,238.72 / $7,943.28
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $9,549.93 / $9,549.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $2,630.27 / $5,888.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $9,549.93 / $9,549.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $2,398.83 / $6,456.54
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,819.70 / $3,311.31