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New York rates for HCPCS 21195

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

Facilitymedian $5,754 · 10th–90th $1,862$12,3030%10%10th90th$5,754Professionalmedian $1,549 · 10th–90th $1,202$3,8020%20%10th90th$1,549$50.0$200.0$1.0K$5.0K$20.0K

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
$1,778.28 / $5,128.61 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,513.56 / $3,548.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $7,762.47 / $13,803.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,445.44 / $3,388.44
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $8,912.51
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $2,238.72 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,137.96 / $6,165.95
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,819.70 / $4,677.35
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,949.84 / $2,951.21
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,737.80 / $2,818.38
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $1,819.70 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $5,495.41 / $12,589.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,819.70 / $5,754.40
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,584.89 / $5,888.44
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,698.24 / $3,981.07