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Colorado rates for HCPCS 21195

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,095.78 / $6,886.00 / $10,651.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,238.90 / $1,338.92 / $1,955.97
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,946.00 / $9,472.00 / $17,487.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,489.37 / $1,903.53 / $3,052.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,599.72 / $5,599.72 / $17,639.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,429.55 / $1,831.49 / $2,750.51
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,338.92 / $1,749.42 / $2,410.06
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,458.24 / $1,922.22 / $2,651.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,168.00 / $11,831.32 / $19,712.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,428.42 / $1,937.45 / $3,097.19