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New Mexico 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
$1,862.09 / $2,344.23 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,479.11 / $3,630.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,803.84 / $30,902.95 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,041.74 / $4,786.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,949.84 / $3,090.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,137.96 / $3,311.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $11,220.18 / $25,703.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,041.74 / $2,754.23