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North Dakota 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 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,995.26 / $4,677.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $4,677.35 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $3,715.35 / $6,025.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $2,630.27 / $5,888.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $3,548.13 / $15,135.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,041.74 / $11,481.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $3,630.78 / $5,011.87