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California rates for HCPCS 21195

Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation

Facilitymedian $10,471 · 10th–90th $3,388$17,7830%5%10%10th90th$10,471Professionalmedian $1,660 · 10th–90th $1,202$5,6230%10%20%10th90th$1,660$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
$3,801.89 / $10,000.00 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,479.11 / $6,309.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $11,481.54 / $17,782.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,089.30 / $4,073.80
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $4,466.84 / $8,128.31
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,905.46 / $3,890.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,762.47 / $7,762.47 / $7,762.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,698.24 / $3,630.78
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,445.44 / $1,949.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,513.56 / $3,019.95
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $22,908.68
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,135.61 / $15,135.61 / $15,135.61
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,698.24 / $2,884.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,737.80 / $3,548.13
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $4,570.88
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,380.38 / $1,995.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $11,748.98 / $25,118.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,412.54 / $3,162.28