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West Virginia 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 $2,188 · 10th–90th $1,413–$3,7150%20%40%10th90th$2,188Professionalmedian $2,138 · 10th–90th $1,995–$3,8900%50%10th90th$2,138$50.0$200.0$1.0K$5.0K

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
$1,412.54 / $2,187.76 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,137.96 / $3,890.45
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,818.38
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $3,715.35 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,235.94 / $19,054.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $16,595.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,454.71 / $3,548.13