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Utah 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
$724.44 / $3,630.78 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $2,754.23 / $6,760.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,737.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $4,786.30 / $8,912.51
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $3,981.07 / $7,244.36
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $5,248.07 / $7,585.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,698.24 / $5,623.41