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Washington rates for HCPCS 21196

Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation

Facilitymedian $5,370 · 10th–90th $1,905$21,8780%5%10%10th90th$5,370Professionalmedian $2,089 · 10th–90th $1,288$4,5710%10%20%10th90th$2,089$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $12,882.50 / $26,302.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,778.28 / $4,897.79
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,589.25 / $16,218.10 / $31,622.78
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,754.23 / $3,890.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $758.58 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,344.23 / $4,265.80
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,951.21 / $7,079.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,884.03 / $5,370.32
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $91.20
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,754.23 / $2,884.03
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,949.84
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,818.38 / $3,715.35
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,964.78 / $16,218.10 / $31,622.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,754.23 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $17,378.01 / $33,884.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,089.30 / $3,715.35
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,513.56 / $2,691.53