go back

Alaska rates for HCPCS 21247

Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,643.31 / $9,774.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,467.30 / $7,875.22 / $7,875.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,982.72 / $5,380.13 / $6,791.12
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,481.08 / $7,875.22 / $11,025.31
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,839.53 / $4,607.43 / $9,353.56
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,880.00 / $7,862.75 / $9,446.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,481.08 / $7,875.22 / $11,025.31
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,392.42 / $7,774.80 / $10,390.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,304.10 / $7,376.93 / $9,469.02