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Maine rates for HCPCS 21246

Reconstruction of mandible or maxilla, subperiosteal implant; complete

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.76 / $904.31 / $1,096.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$884.57 / $1,144.74 / $1,614.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$857.42 / $1,307.59 / $1,850.86
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.41 / $1,219.95 / $1,871.47
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.76 / $983.82 / $1,096.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$745.37 / $1,178.52 / $2,137.88