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Maine rates for HCPCS 21199

Osteotomy, mandible, segmental; with genioglossus advancement

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.29 / $1,076.61 / $1,325.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,057.89 / $1,369.03 / $1,931.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,218.35 / $1,590.35 / $2,210.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,261.74 / $1,459.83 / $2,239.46
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$919.76 / $1,143.88 / $1,325.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,007.22 / $1,404.58 / $2,027.74