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Connecticut 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
$4,365.16 / $7,079.46 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,344.23 / $5,623.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $15,135.61 / $16,595.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $3,715.35 / $5,248.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $3,388.44 / $5,623.41
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,570.40 / $4,570.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $10,232.93 / $16,218.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $3,019.95 / $5,623.41