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West Virginia 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
$1,400.00 / $2,114.56 / $24,738.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,298.96 / $1,484.27 / $2,237.25
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,364.64 / $1,494.44 / $1,784.16
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$813.70 / $1,585.92 / $1,585.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,599.88 / $1,599.88 / $1,599.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,366.86 / $2,040.13 / $4,179.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,118.78 / $1,645.97 / $2,288.54