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Pennsylvania rates for HCPCS 21125

Augmentation, mandibular body or angle; prosthetic material

Facilitymedian $6,607 · 10th–90th $1,445–$11,2200%10%10th90th$6,607Professionalmedian $2,344 · 10th–90th $631–$3,8900%10%20%10th90th$2,344$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$1,445.44 / $6,918.31 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $2,344.23 / $3,890.45
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $7,585.78 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $2,089.30 / $4,786.30
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $4,265.80 / $5,370.32
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $3,019.95 / $4,365.16
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $5,248.07 / $9,549.93
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $2,290.87 / $3,467.37
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $3,981.07 / $7,413.10
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $645.65 / $2,511.89
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $645.65 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,981.07 / $19,054.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,584.89 / $4,466.84