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California 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 $8,128 · 10th–90th $3,388–$16,9820%5%10%10th90th$8,128Professionalmedian $2,818 · 10th–90th $1,995–$8,3180%10%20%10th90th$2,818$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
$3,981.07 / $10,000.00 / $21,877.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,630.27 / $8,317.64
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $3,630.78 / $4,786.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $8,128.31 / $15,848.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,311.31 / $6,606.93
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $7,079.46 / $13,489.63
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,090.30 / $6,165.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,754.23 / $5,623.41
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,187.76 / $2,951.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,344.23 / $8,511.38
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $16,982.44
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19,952.62 / $19,952.62 / $19,952.62
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,754.23 / $4,677.35
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,754.23 / $5,623.41
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,244.36 / $7,244.36 / $7,244.36
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,238.72 / $3,162.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $11,748.98 / $25,118.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,344.23 / $5,011.87