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Oklahoma rates for HCPCS 21245

Reconstruction of mandible or maxilla, subperiosteal implant; partial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,346.00 / $5,511.00 / $16,900.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$931.40 / $1,007.86 / $1,225.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,334.45 / $14,829.12 / $23,429.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$917.70 / $1,233.91 / $1,630.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,807.86 / $6,807.86 / $6,807.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.39 / $1,335.68 / $1,782.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$963.63 / $1,365.52 / $8,753.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,019.92 / $1,313.19 / $11,980.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,481.00 / $5,910.00 / $9,232.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$998.38 / $1,223.98 / $1,800.17