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Upper Jaw Repositioning Surgery, Two-Segment

Wisconsin rates for HCPCS 21142

This surgery cuts and repositions the upper jaw bone to correct a bite or facial alignment problem, dividing the jaw into two separate pieces so each can be moved into the right position independently. It does not involve adding bone graft material. It's used when the correction needed is more complex than moving the jaw as a single piece, but not as complex as dividing it into three or more segments.

Facilitymedian $10,000 · 10th–90th $3,311$16,9820%5%10%10th90th$10,000Professionalmedian $2,188 · 10th–90th $1,288$6,0260%20%10th90th$2,188$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
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$2,818.38
Typical High
$14,454.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,258.93
Median
$1,380.38
Typical High
$3,715.35
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,606.93
Median
$10,964.78
Typical High
$18,197.01
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$2,818.38
Typical High
$7,585.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$4,168.69
Typical High
$6,760.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$5,623.41
Typical High
$6,309.57
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$3,019.95
Typical High
$7,244.36
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$2,454.71
Median
$3,311.31
Typical High
$4,265.80
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$3,162.28
Typical High
$15,135.61
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$2,511.89
Typical High
$13,182.57
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$85.11
Network Health
Setting
Facility
Modifier
Global
Typical Low
$2,754.23
Median
$9,332.54
Typical High
$15,848.93
Network Health
Setting
Professional
Modifier
Global
Typical Low
$1,698.24
Median
$3,311.31
Typical High
$5,888.44
Quartz
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$2,951.21
Typical High
$4,365.16
Quartz
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$12,589.25
Typical High
$12,589.25
Quartz
Setting
Professional
Modifier
Global
Typical Low
$2,454.71
Median
$6,760.83
Typical High
$13,182.57
Security Health
Setting
Professional
Modifier
Global
Typical Low
$4,466.84
Median
$4,466.84
Typical High
$4,466.84
Security Health
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$7,762.47
Typical High
$8,709.64
United
Setting
Facility
Modifier
Global
Typical Low
$7,585.78
Median
$12,022.64
Typical High
$15,848.93
United
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$2,089.30
Typical High
$5,623.41