go back

Wisconsin rates for HCPCS 21196

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

Facilitymedian $10,233 · 10th–90th $4,169–$17,7830%5%10%10th90th$10,233Professionalmedian $2,344 · 10th–90th $1,349–$6,1660%10%10th90th$2,344$50.0$200.0$1.0K$5.0K$20.0K

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
$1,412.54 / $4,168.69 / $23,442.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,445.44 / $4,677.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,951.21 / $7,079.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,365.16 / $6,918.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $5,888.44 / $6,606.93
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $3,090.30 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,467.37 / $4,466.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $3,311.31 / $15,135.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,019.95 / $15,848.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,548.13 / $6,025.60
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,090.30 / $4,570.88
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $13,182.57 / $13,182.57
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $6,918.31 / $15,848.93
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $4,786.30
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $7,762.47 / $9,120.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,570.40 / $5,754.40