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New Hampshire rates for HCPCS 21215

Graft, bone; mandible (includes obtaining graft)

Facilitymedian $5,623 · 10th–90th $2,399–$22,3870%10%10th90th$5,623Professionalmedian $1,995 · 10th–90th $871–$8,5110%5%10th90th$1,995$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $5,370.32 / $22,387.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $2,137.96 / $6,456.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,623.41 / $9,120.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,513.56 / $2,137.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $3,162.28 / $10,964.78
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $3,467.37 / $9,332.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $2,754.23 / $10,232.93
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $5,248.07