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New Jersey 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
$1,355.57 / $6,628.00 / $11,798.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,186.61 / $1,358.88 / $2,250.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,262.49 / $1,945.57 / $4,005.55
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,550.87 / $2,058.42 / $2,097.66
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,606.42 / $14,382.16 / $31,187.56
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,116.42 / $1,618.01 / $3,496.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,885.00 / $8,558.00 / $15,604.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,095.08 / $1,699.32 / $4,115.14