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Pennsylvania rates for HCPCS 21127

Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $3,467.37 / $6,165.95
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $2,238.72 / $6,606.93
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $6,606.93 / $8,317.64
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $4,570.88 / $10,000.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $3,630.78 / $8,912.51
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,288.25 / $9,120.11
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,096.48 / $3,801.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,737.80 / $5,888.44