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Massachusetts 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
$1,924.00 / $2,669.00 / $5,270.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,298.96 / $1,484.27 / $4,640.31
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,570.74 / $4,809.60 / $13,073.36
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,402.98 / $2,535.87 / $15,789.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,434.40 / $2,342.38 / $4,123.52
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,424.41 / $2,303.58 / $7,315.92
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,634.51 / $1,979.93 / $2,702.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,757.18 / $3,440.56 / $4,479.05
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.82 / $0.82 / $0.82
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,063.00 / $13,073.36
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,551.39 / $2,623.10 / $15,789.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,324.00 / $5,097.00 / $10,764.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,477.51 / $2,220.09 / $4,627.39