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Arizona rates for HCPCS 21175

Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining autografts)

Facilitymedian $4,898 · 10th–90th $2,089–$9,3330%10%10th90th$4,898Professionalmedian $2,344 · 10th–90th $1,995–$5,8880%20%10th90th$2,344$100.0$500.0$2.0K$10.0K

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
$2,089.30 / $4,786.30 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,290.87 / $6,025.60
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $7,413.10 / $13,489.63
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,019.95 / $5,754.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,511.89 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,019.95 / $8,128.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,630.27 / $19,498.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $5,495.41 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,290.87 / $3,981.07