go back

Colorado 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
$1,590.56 / $6,479.00 / $12,556.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,198.39 / $1,423.15 / $2,031.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,946.00 / $9,472.00 / $17,487.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,581.03 / $2,014.85 / $3,231.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,178.55 / $4,178.55 / $13,162.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,506.12 / $1,952.89 / $2,863.24
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,423.15 / $1,852.69 / $2,561.67
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,549.97 / $2,043.14 / $2,818.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,251.00 / $11,924.00 / $19,712.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,491.53 / $2,062.01 / $3,214.37