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Missouri 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
$1,443.98 / $4,908.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,207.82 / $1,443.98 / $2,279.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,385.00 / $1,714.42 / $2,705.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,367.59 / $1,935.63 / $3,197.85
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,187.44 / $1,978.25 / $4,813.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,405.05 / $2,042.70 / $15,789.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,858.00 / $4,000.00 / $11,258.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,329.76 / $1,846.89 / $3,008.58