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Colorado 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,551.00 / $6,028.00 / $10,651.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,001.22 / $2,190.62 / $3,435.06
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,946.00 / $9,472.00 / $17,487.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,366.80 / $3,098.98 / $4,969.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,388.71 / $3,033.19 / $4,440.13
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,190.62 / $2,872.51 / $3,943.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,385.82 / $3,144.95 / $4,337.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,168.00 / $11,831.32 / $19,712.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,323.81 / $3,174.33 / $6,378.16