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North Dakota 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
$1,432.72 / $1,432.72 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,269.08 / $1,405.52 / $2,279.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,820.78 / $3,103.00 / $3,638.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,770.28 / $3,536.78 / $4,711.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,432.72 / $1,737.67 / $2,440.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,477.51 / $2,676.69 / $3,725.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,477.51 / $2,627.07 / $3,250.52