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Minnesota 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
$1,995.26 / $1,995.26 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,995.26 / $3,388.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,120.11 / $14,791.08 / $42,657.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,388.44 / $5,011.87 / $7,762.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $7,079.46 / $16,982.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,467.37 / $5,754.40 / $8,511.38
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $6,760.83 / $13,489.63
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,630.78 / $4,786.30 / $7,762.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $3,548.13 / $9,772.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $3,715.35 / $10,715.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $5,754.40 / $12,589.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $3,715.35 / $7,244.36