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North Carolina rates for HCPCS 21195

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

Facilitymedian $4,365 · 10th–90th $1,380–$12,0230%10%20%10th90th$4,365Professionalmedian $1,585 · 10th–90th $1,202–$3,7150%10%20%10th90th$1,585$100.0$500.0$2.0K$10.0K

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
$1,862.09 / $8,709.64 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,412.54 / $2,818.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,737.80 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $7,079.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,819.70 / $2,951.21
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $3,162.28
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,778.28 / $2,884.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,290.87 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $11,748.98 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,479.11 / $2,884.03
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $22,908.68 / $22,908.68
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,135.61 / $15,135.61 / $15,135.61