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North Dakota 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
$1,451.16 / $1,451.16 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,198.39 / $1,424.31 / $1,451.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,807.36 / $3,094.32 / $3,628.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,760.99 / $3,518.22 / $4,686.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,451.16 / $1,767.65 / $2,466.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,488.34 / $2,652.07 / $3,778.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,488.34 / $2,652.07 / $3,274.35