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New Mexico 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
$1,000.00 / $7,838.38 / $8,644.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,116.53 / $1,266.16 / $1,995.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,187.99 / $1,808.78 / $2,445.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,890.70
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,159.94 / $1,559.54 / $3,362.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,291.99 / $1,943.73 / $3,012.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$899.00 / $11,259.00 / $16,897.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,315.60 / $1,804.54 / $2,869.19