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Delaware 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
$6,316.00 / $6,316.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,786.13 / $2,114.48 / $2,114.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,630.16 / $2,004.31 / $3,745.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,530.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.31 / $1,911.78 / $4,771.39