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Utah rates for HCPCS 21210

Graft Bone Nasal/Maxillary/Malar Areas

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,186.39 / $3,977.00 / $9,932.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.26 / $1,672.86 / $4,147.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$919.77 / $2,109.77 / $3,203.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.82 / $1,029.23 / $1,617.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,413.68 / $11,103.62 / $16,181.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$989.53 / $2,190.92 / $5,216.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $7,693.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,695.59 / $2,204.27 / $3,948.60