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Wisconsin rates for HCPCS 21172

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

Facilitymedian $10,233 · 10th–90th $4,677–$16,9820%5%10%10th90th$10,233Professionalmedian $2,884 · 10th–90th $1,905–$8,3180%10%10th90th$2,884$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
$1,949.84 / $4,073.80 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,089.30 / $5,128.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,981.07 / $9,772.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $6,025.60 / $9,549.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $8,128.31 / $9,120.11
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $4,073.80 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,677.35 / $6,025.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $4,073.80 / $15,135.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,388.44 / $15,135.61
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $4,466.84 / $8,128.31
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $5,011.87 / $7,244.36
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $19,054.61 / $19,054.61
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $9,332.54 / $14,454.40
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $6,456.54 / $6,456.54
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,754.40 / $10,964.78 / $12,589.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,951.21 / $7,943.28