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Oregon 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 $4,266 · 10th–90th $2,818–$15,8490%20%10th90th$4,266Professionalmedian $3,548 · 10th–90th $1,995–$5,8880%10%20%10th90th$3,548$50.0$200.0$1.0K$5.0K$20.0K$100.0K$500.0K

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
$4,365.16 / $5,623.41 / $15,848.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,290.87 / $5,888.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,073.80 / $5,754.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $4,168.69 / $5,248.07
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,467.37 / $5,370.32
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,981.07 / $5,623.41
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $4,073.80 / $4,466.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,467.37 / $5,128.61
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $4,265.80 / $5,888.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,803.84 / $19,054.61 / $22,908.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $5,011.87 / $6,606.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $17,782.79 / $25,703.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $4,265.80 / $5,888.44