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Wisconsin rates for HCPCS 21193

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

Facilitymedian $9,772 · 10th–90th $3,236–$16,9820%5%10%10th90th$9,772Professionalmedian $1,820 · 10th–90th $1,122–$5,4950%10%20%10th90th$1,820$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $8,511.38 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,230.27 / $3,090.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,511.89 / $6,309.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,801.89 / $6,025.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $5,011.87 / $5,754.40
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,691.53 / $7,244.36
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,951.21 / $3,801.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,818.38 / $15,135.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,238.72 / $14,791.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $3,019.95 / $5,248.07
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,630.27 / $3,890.45
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $13,803.84 / $13,803.84
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $6,165.95 / $14,791.08
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $4,073.80
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $6,918.31 / $7,943.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,905.46 / $5,128.61