go back

Arizona rates for HCPCS 21196

Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $4,365.16 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,778.28 / $4,786.30
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $1,288.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $5,370.32 / $7,943.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,995.26 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,698.24 / $2,951.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,995.26 / $8,128.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,737.80 / $15,848.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $5,495.41 / $8,709.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,479.11 / $2,570.40