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Oklahoma 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
$1,445.44 / $3,890.45 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,238.72 / $4,073.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $3,019.95 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,951.21 / $3,548.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $3,311.31 / $9,332.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,511.89 / $19,498.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $5,754.40 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,238.72 / $3,019.95