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Delaware 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
$6,316.00 / $6,316.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,218.15 / $1,345.51 / $1,345.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,289.37 / $4,289.37 / $4,289.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,166.81 / $1,384.96 / $2,427.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,530.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,157.36 / $1,419.49 / $3,129.23