go back

Maine rates for HCPCS 21194

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

Facilitymedian $12,023 · 10th–90th $12,023–$12,0230%50%100%$12,023Professionalmedian $1,738 · 10th–90th $1,318–$3,5480%10%10th90th$1,738$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,621.81 / $3,548.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,041.74 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,089.30 / $3,162.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,905.46 / $3,630.78
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,513.56 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $12,022.64 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,819.70 / $3,019.95