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Utah rates for HCPCS 21206

Osteotomy, maxilla, segmental (eg, Wassmund or Schuchard)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,288.25 / $5,248.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,513.56 / $2,089.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $2,754.23
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,949.84 / $3,162.28
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,778.28 / $2,754.23
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,445.44 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,202.26 / $1,862.09