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Oklahoma 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
$1,392.00 / $4,856.00 / $14,100.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,133.08 / $1,296.18 / $1,296.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,334.45 / $14,829.12 / $23,429.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,421.23 / $1,684.42 / $2,071.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $900.00 / $900.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,294.65 / $1,638.56 / $1,992.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,228.92 / $1,722.29 / $8,124.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,097.59 / $1,395.95 / $14,942.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,481.00 / $5,910.00 / $9,232.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.03 / $1,291.29 / $1,828.98