go back

California 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
$3,548.13 / $8,912.51 / $21,379.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,737.80 / $6,025.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $11,481.54 / $17,782.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,187.76 / $4,365.16
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $100.00 / $8,128.31
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $2,089.30 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,819.70 / $3,801.89
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,513.56 / $2,041.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,621.81 / $3,467.37
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $56.23 / $13,182.57
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,848.93 / $15,848.93 / $15,848.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $2,041.74
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,819.70 / $2,951.21
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,862.09 / $3,801.89
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,677.35 / $4,677.35 / $4,677.35
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,548.82 / $2,238.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $12,302.69 / $25,703.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,513.56 / $3,162.28