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Connecticut rates for HCPCS 21193

Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,943.00 / $7,629.00 / $13,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,043.18 / $1,262.13 / $3,123.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,920.00 / $11,936.00 / $15,915.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,109.75 / $2,443.11 / $3,416.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$843.00 / $843.00 / $843.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.08 / $2,223.44 / $3,181.06
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,330.14 / $4,873.00 / $4,974.00
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,048.01 / $1,866.52 / $2,373.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,644.00 / $8,468.00 / $13,943.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,102.97 / $2,081.71 / $3,699.38