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Texas rates for HCPCS 21195

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

Facilitymedian $4,074 · 10th–90th $1,148–$12,8820%5%10th90th$4,074Professionalmedian $1,479 · 10th–90th $1,175–$2,3990%10%20%10th90th$1,479$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
$1,096.48 / $3,715.35 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,412.54 / $2,344.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $7,762.47 / $15,135.61
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,548.82 / $2,041.74
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $1,202.26 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,778.28 / $2,818.38
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $22,908.68
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,135.61 / $15,135.61 / $15,135.61
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,819.70 / $4,897.79
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,737.80 / $2,818.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $169.82 / $1,122.02
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,479.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,698.24 / $3,162.28
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,778.28 / $2,818.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $6,165.95 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,479.11 / $2,238.72
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,202.26 / $1,258.93