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Idaho 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
$3,581.30 / $7,841.48 / $16,962.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,350.00 / $1,796.76 / $2,984.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,608.55 / $2,192.23 / $2,683.19
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,369.68 / $2,570.57 / $3,611.15
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,289.64 / $2,497.79 / $3,399.06
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $2,001.34 / $2,517.82
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,662.17 / $14,534.58 / $18,446.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,416.80 / $2,843.29 / $3,399.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $10,120.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,555.71 / $2,140.80 / $3,029.56