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Georgia 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
$2,884.03 / $5,370.32 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,511.89 / $5,495.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $3,801.89 / $6,918.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,467.37 / $4,786.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $2,511.89 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $3,467.37 / $5,623.41
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,162.28 / $12,302.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $6,456.54 / $12,022.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,884.03 / $4,897.79