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Arkansas rates for HCPCS 21172

Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $2,187.76 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,137.96 / $2,951.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $5,370.32 / $7,413.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $2,884.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,691.53 / $3,467.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $4,073.80 / $11,748.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,344.23 / $3,715.35