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Michigan 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 $5,754 · 10th–90th $4,677–$7,9430%20%10th90th$5,754Professionalmedian $2,512 · 10th–90th $1,995–$5,4950%20%10th90th$2,512$500.0$1.0K$2.0K$5.0K$10.0K$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
$4,897.79 / $4,897.79 / $5,754.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,290.87 / $5,888.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,630.78 / $3,801.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,630.27 / $3,548.13
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $5,754.40 / $7,413.10
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,818.38 / $5,128.61
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,630.27 / $3,548.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $7,762.47 / $14,791.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,630.27 / $3,467.37