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New Mexico 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
$1,000.00 / $7,838.38 / $8,644.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,210.66 / $1,384.52 / $7,347.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,345.93 / $15,935.67 / $25,966.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,251.91 / $1,924.90 / $2,502.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $2,042.85
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,250.46 / $1,650.30 / $3,280.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,315.96 / $2,039.73 / $3,295.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,315.00 / $11,259.00 / $12,494.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,423.44 / $1,961.96 / $3,060.91