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Utah 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 $3,162–$11,2200%10%10th90th$6,026Professionalmedian $2,754 · 10th–90th $1,905–$10,9650%10%10th90th$2,754$50.0$200.0$1.0K$5.0K$20.0K

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
$2,511.89 / $6,025.60 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,511.89 / $10,964.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,511.89 / $4,466.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $3,801.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $11,481.54 / $17,782.79
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,548.13 / $4,786.30
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,890.45 / $5,011.87
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,090.30 / $4,897.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,089.30 / $3,311.31