go back

Indiana rates for HCPCS 21179

Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $4,897.79 / $16,218.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,513.56 / $2,818.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $19,952.62 / $27,542.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,949.84 / $3,090.30
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,513.56 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,905.46 / $3,311.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $10,000.00 / $18,197.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,621.81 / $2,818.38