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New Hampshire rates for HCPCS 21246

Reconstruction of mandible or maxilla, subperiosteal implant; complete

Facilitymedian $5,370 · 10th–90th $2,399–$22,3870%10%20%10th90th$5,370Professionalmedian $1,230 · 10th–90th $851–$2,1380%10%10th90th$1,230$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,019.95 / $22,387.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,000.00 / $1,778.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,623.41 / $9,120.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,621.81 / $2,238.72
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,348.96 / $2,570.40
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,288.25 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,348.96 / $2,454.71
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $1,023.29