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Indiana rates for HCPCS 21215

Graft Bone Mandible

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.99 / $3,826.33 / $17,225.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.99 / $1,553.15 / $4,107.51
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,719.00 / $11,294.00 / $22,813.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.28 / $1,098.30 / $1,510.15
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$732.62 / $952.41 / $4,973.59
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,586.73 / $4,304.08 / $5,380.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,167.31 / $5,167.31 / $6,125.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$798.45 / $1,733.72 / $5,793.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,472.00 / $10,113.00 / $15,750.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,660.57 / $3,921.74 / $7,278.21