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North Carolina 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
$1,615.00 / $3,065.84 / $12,615.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,807.79 / $2,056.19 / $3,811.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,001.37 / $2,883.85 / $5,194.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.10 / $606.10 / $606.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,943.01 / $2,671.24 / $4,544.20
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,056.19 / $2,285.10 / $3,711.87
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,216.76 / $2,549.00 / $2,671.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $2,746.30 / $4,811.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,306.00 / $10,968.00 / $17,964.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,674.57 / $2,341.38 / $4,993.26
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $18,995.43 / $18,995.43
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,610.56 / $14,610.56 / $18,890.63