go back

Hawaii 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 $6,026 · 10th–90th $2,570–$6,0260%50%10th$6,026Professionalmedian $2,512 · 10th–90th $1,995–$4,7860%20%10th90th$2,512$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$2,570.40 / $6,025.60 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,290.87 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,754.23 / $3,311.31
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,467.37 / $3,801.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,344.23 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,454.71 / $3,467.37
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $1,995.26 / $3,548.13