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Kansas 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
$2,818.38 / $5,623.41 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,412.54 / $2,344.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,737.80 / $2,691.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $1,949.84 / $7,244.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,737.80 / $14,454.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $4,677.35 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,621.81 / $2,238.72