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Wyoming rates for HCPCS 21193

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,231.58 / $1,246.25 / $1,584.58
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,006.39 / $5,006.39 / $5,006.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,343.00 / $2,812.00 / $4,254.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,620.74 / $2,431.11 / $3,418.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,188.00 / $5,188.00 / $18,767.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,416.36 / $2,511.60 / $4,265.30