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Pennsylvania rates for HCPCS 21296

Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach

Facilitymedian $2,692 · 10th–90th $832–$8,3180%5%10%10th90th$2,692Professionalmedian $427 · 10th–90th $363–$7760%20%40%10th90th$427$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $426.58 / $707.95
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $7,585.78 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $416.87 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $478.63 / $794.33
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $602.56 / $758.58
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $457.09 / $676.08
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,995.26 / $7,244.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $426.58 / $1,230.27
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $549.54 / $1,000.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $398.11 / $524.81
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $426.58 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,981.07 / $10,715.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $457.09 / $831.76