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Arkansas rates for HCPCS 21194

Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; with bone graft (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.00 / $1,782.00 / $9,034.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,274.49 / $1,475.71 / $1,982.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,517.07 / $1,896.34 / $2,007.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,590.72 / $2,143.23 / $2,658.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,565.00 / $2,828.00 / $6,957.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,294.85 / $1,649.60 / $2,711.93