go back

Pennsylvania rates for HCPCS 21249

Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,380.38 / $2,884.03
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,584.89 / $2,630.27
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,290.87 / $2,884.03
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,737.80 / $2,951.21
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,737.80 / $3,981.07
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $2,089.30 / $3,311.31
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,071.52 / $1,318.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,479.11 / $2,454.71