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Kansas 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
$2,757.00 / $6,071.00 / $13,151.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,290.20 / $1,436.35 / $2,285.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,341.75 / $2,755.00 / $2,755.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$624.00 / $624.00 / $624.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,518.82 / $1,891.09 / $2,809.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,220.90 / $1,993.01 / $5,323.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,488.34 / $1,755.38 / $17,154.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,967.00 / $4,960.00 / $11,732.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,469.75 / $1,711.59 / $2,482.53