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Kansas 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
$3,131.00 / $6,560.00 / $13,151.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,001.22 / $2,229.53 / $3,486.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,814.94 / $3,311.69 / $3,311.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$624.00 / $624.00 / $624.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,313.30 / $3,157.15 / $4,386.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,838.00 / $2,992.60 / $6,213.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,254.10 / $2,788.57 / $19,652.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,972.00 / $4,916.00 / $11,732.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,254.10 / $2,671.23 / $3,698.62