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Nebraska 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
$4,570.88 / $7,943.28 / $15,135.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,137.96 / $10,964.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,120.11 / $11,748.98 / $22,908.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $3,090.30 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $4,570.88 / $4,570.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $4,466.84 / $5,623.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $3,235.94 / $9,772.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,548.13 / $15,135.61
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $4,466.84 / $6,606.93
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $4,570.88 / $4,570.88
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $4,570.88 / $6,606.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,309.57 / $7,413.10 / $9,120.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,548.13 / $4,786.30