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Wisconsin rates for HCPCS 21194

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

Facilitymedian $10,233 · 10th–90th $3,715–$16,9820%5%10%10th90th$10,233Professionalmedian $2,089 · 10th–90th $1,318–$6,4570%10%10th90th$2,089$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
$1,412.54 / $2,951.21 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,412.54 / $3,548.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,951.21 / $7,943.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,365.16 / $6,918.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $5,888.44 / $6,606.93
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $3,019.95 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,467.37 / $4,466.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $3,235.94 / $15,135.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,570.40 / $16,982.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,311.31 / $6,165.95
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,090.30 / $4,466.84
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $16,595.87 / $16,595.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $7,079.46 / $16,982.44
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,677.35 / $4,677.35 / $4,677.35
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $7,943.28 / $9,120.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,187.76 / $5,888.44