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Maryland 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
$6,731.96 / $6,731.96 / $6,731.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,269.08 / $1,484.27 / $3,702.31
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,677.25 / $1,731.28 / $2,198.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.00 / $507.00 / $641.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,342.88 / $1,865.27 / $3,285.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,472.74 / $1,899.83 / $2,498.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.00 / $847.00 / $1,560.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,118.78 / $1,623.90 / $3,022.62
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,381.46 / $1,693.65 / $2,106.32