go back

Mississippi 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
$875.00 / $1,831.00 / $2,825.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,213.43 / $1,331.40 / $2,939.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,045.96 / $5,045.96 / $5,045.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,166.00 / $2,166.00 / $2,166.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,612.83 / $4,044.53 / $6,486.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,316.67 / $2,144.46 / $2,812.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$985.00 / $3,968.00 / $10,251.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,212.93 / $1,522.48 / $3,053.38