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Nebraska rates for HCPCS 21246

Reconstruction of mandible or maxilla, subperiosteal implant; complete

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,241.22 / $11,611.47 / $24,068.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.24 / $794.24 / $4,570.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,086.90 / $11,951.75 / $23,118.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$761.05 / $1,297.26 / $1,729.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,376.03 / $4,376.03 / $4,376.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,337.00 / $1,943.08 / $2,613.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.24 / $1,389.92 / $8,632.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,072.41 / $1,725.29 / $2,417.94
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,585.97 / $2,105.37 / $6,084.70
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,454.00 / $1,748.99 / $2,613.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,178.00 / $7,441.00 / $8,816.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,072.41 / $1,821.61 / $2,248.02