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Wyoming rates for HCPCS 21210

Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$771.41 / $984.39 / $2,608.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,006.39 / $5,006.39 / $5,006.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,452.00 / $2,197.00 / $5,085.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,191.28 / $2,584.08 / $5,246.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,188.00 / $5,188.00 / $18,767.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,510.29 / $3,977.57 / $6,935.49