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Wisconsin rates for HCPCS 21125

Augmentation, mandibular body or angle; prosthetic material

Facilitymedian $8,511 · 10th–90th $2,512$16,9820%5%10%10th90th$8,511Professionalmedian $2,455 · 10th–90th $646$6,9180%10%10th90th$2,455$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
$660.69 / $2,630.27 / $13,489.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $2,398.83 / $4,365.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $10,232.93 / $17,378.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,905.46 / $4,168.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,079.46 / $8,317.64 / $13,182.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $3,090.30 / $12,302.69
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $2,630.27 / $6,606.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,630.27 / $7,079.46
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $2,754.23 / $8,128.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $6,025.60 / $19,054.61
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,023.29
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $5,754.40 / $7,762.47
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $4,677.35 / $9,549.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $3,090.30 / $8,511.38
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $14,125.38 / $20,892.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $13,803.84 / $18,197.01
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $9,120.11
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $4,265.80 / $16,595.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $7,585.78 / $9,772.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $2,818.38 / $9,549.93