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Washington rates for HCPCS 21206

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,288.25 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,737.80 / $2,951.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $2,041.74 / $5,248.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $120.23
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,041.74 / $2,818.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,819.70 / $2,570.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,698.24 / $2,884.03
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,023.29 / $1,659.59