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Arkansas rates for HCPCS 21245

Reconstruction of mandible or maxilla, subperiosteal implant; partial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,698.24 / $3,162.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,148.15 / $1,548.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $5,370.32 / $7,413.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,288.25 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,445.44 / $1,949.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $3,981.07 / $11,748.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,258.93 / $1,905.46