go back

Minnesota 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
$1,457.07 / $1,457.07 / $6,575.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,298.96 / $1,457.07 / $3,202.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,333.71 / $11,518.20 / $22,492.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,482.82 / $3,978.05 / $5,190.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,506.22 / $4,974.82 / $11,967.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,621.90 / $4,176.62 / $6,202.92
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,187.47 / $4,548.18 / $9,423.31
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,373.78 / $3,740.27 / $5,688.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,525.87 / $2,507.79 / $7,240.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,620.80 / $2,880.59 / $5,744.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,940.00 / $7,872.00 / $11,531.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,620.80 / $2,897.40 / $5,365.83