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Washington rates for HCPCS 21194

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

Facilitymedian $3,631 · 10th–90th $1,738$19,9530%10%10th90th$3,631Professionalmedian $1,950 · 10th–90th $1,288$3,8020%20%10th90th$1,950$50.0$200.0$1.0K$5.0K$20.0K

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
$2,691.53 / $8,128.31 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,621.81 / $3,548.13
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,589.25 / $16,218.10 / $31,622.78
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,754.23 / $3,890.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $870.96 / $8,317.64
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,344.23 / $4,265.80
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,884.03 / $9,120.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,818.38 / $6,918.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $91.20
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,754.23 / $2,884.03
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,949.84
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,818.38 / $3,715.35
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,964.78 / $16,218.10 / $31,622.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,754.23 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $17,378.01 / $33,884.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,041.74 / $3,715.35
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,479.11 / $2,691.53