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Oregon rates for HCPCS 21195

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

Facilitymedian $2,630 · 10th–90th $1,820–$14,4540%20%10th90th$2,630Professionalmedian $2,188 · 10th–90th $1,259–$3,6310%10%20%10th90th$2,188$20.0$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
$2,754.23 / $3,467.37 / $15,848.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,412.54 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,511.89 / $3,630.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,630.27 / $3,235.94
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,187.76 / $3,388.44
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,454.71 / $3,467.37
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,630.27 / $2,691.53
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,187.76 / $3,235.94
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $2,570.40 / $3,630.78
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,803.84 / $19,054.61 / $22,908.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,090.30 / $3,981.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $17,782.79 / $25,703.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,630.27 / $3,548.13