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Idaho 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 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,344.23 / $4,168.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $7,244.36 / $15,135.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,311.31 / $3,801.89 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,691.53 / $3,467.37
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $3,090.30 / $5,011.87
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $3,890.45 / $5,248.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $13,182.57 / $18,620.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $4,073.80 / $4,466.84
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,398.83 / $10,964.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $10,232.93 / $27,542.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,884.03 / $4,168.69