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Maryland rates for HCPCS 21246

Reconstruction of mandible or maxilla, subperiosteal implant; complete

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $870.96 / $2,238.72
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $933.25 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,071.52 / $1,949.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $891.25 / $1,513.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $851.14 / $2,884.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $954.99 / $1,737.80
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $954.99 / $1,230.27