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Pennsylvania rates for HCPCS 21172

Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)

Facilitymedian $6,026 · 10th–90th $1,445–$10,4710%10%20%10th90th$6,026Professionalmedian $2,138 · 10th–90th $1,778–$3,7150%20%10th90th$2,138$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $6,165.95 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,137.96 / $3,630.78
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $10,000.00 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,290.87 / $4,073.80
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,311.31 / $4,365.16
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,630.27 / $3,548.13
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141,253.75 / $141,253.75 / $141,253.75
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $4,786.30 / $8,709.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,137.96 / $4,570.88
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,019.95 / $4,265.80
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,187.76
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,187.76 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $5,754.40 / $19,054.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,290.87 / $4,168.69