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New Hampshire rates for HCPCS 21194

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

Facilitymedian $5,012 · 10th–90th $2,399–$14,7910%20%10th90th$5,012Professionalmedian $2,042 · 10th–90th $1,413–$3,4670%10%10th90th$2,042$100.0$200.0$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $5,011.87 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,659.59 / $2,951.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,623.41 / $9,120.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,691.53 / $3,801.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,238.72 / $4,265.80
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,137.96 / $3,235.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,187.76 / $3,981.07
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $1,698.24