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Washington, DC 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
$1,621.81 / $5,128.61 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,621.81 / $4,466.84
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $1,862.09 / $11,748.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,454.71 / $4,365.16
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $3,388.44 / $3,548.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $16,218.10 / $33,884.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,089.30 / $4,365.16