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New Jersey 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
$4,466.84 / $8,511.38 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,290.87 / $7,943.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $3,019.95 / $6,760.83
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,398.83 / $3,311.31
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $19,054.61 / $30,199.52
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,884.03 / $5,888.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $9,120.11 / $21,379.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,238.72 / $5,754.40