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Kentucky 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
$851.14 / $2,818.38 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,584.89 / $2,818.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $10,715.19 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,621.81 / $2,398.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $1,949.84 / $2,511.89
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $1,949.84 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $2,691.53 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,630.27 / $10,232.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,445.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $4,677.35 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,949.84 / $3,162.28