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Nebraska 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
$4,241.22 / $10,431.19 / $21,899.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,150.74 / $1,150.74 / $6,135.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,522.85 / $8,579.33 / $16,595.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,101.81 / $1,878.09 / $2,504.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,868.00 / $2,811.77 / $3,785.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,150.74 / $2,013.80 / $8,632.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,555.01 / $2,571.73 / $3,504.48
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,397.21 / $2,784.77 / $3,818.64
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,881.00 / $2,571.23 / $3,785.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,178.00 / $7,441.00 / $8,816.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,555.01 / $2,571.73 / $3,349.25