go back

West Virginia 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
$1,400.00 / $1,530.23 / $2,352.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,530.23 / $1,628.46 / $2,293.44
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,518.01 / $1,660.12 / $1,984.68
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$905.11 / $1,764.16 / $1,764.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,772.98 / $1,772.98 / $1,772.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,512.13 / $2,300.48 / $4,376.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,262.40 / $1,809.68 / $2,570.26