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Idaho rates for HCPCS 21215

Graft Bone Mandible

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,722.60 / $4,500.00 / $10,201.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.85 / $3,374.21 / $8,572.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,628.78 / $4,628.78 / $4,641.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,009.77 / $3,037.99 / $7,135.73
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$799.56 / $3,435.88 / $9,086.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,285.73 / $5,365.62 / $7,749.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $5,483.34 / $6,898.40
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,660.78 / $14,097.25 / $17,807.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,338.70 / $3,846.30 / $8,502.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $10,120.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,238.99 / $6,085.98 / $8,837.14