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New Jersey 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
$1,433.87 / $6,396.00 / $11,298.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,226.58 / $1,410.00 / $2,361.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,331.18 / $2,039.74 / $4,457.67
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,649.86 / $2,188.80 / $2,226.42
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,180.88 / $13,851.67 / $25,525.77
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,156.70 / $1,714.14 / $3,484.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,682.00 / $9,969.00 / $19,696.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,164.22 / $1,914.73 / $4,271.21