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Maine 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
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,737.80 / $4,073.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $2,238.72 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,137.96 / $3,388.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,995.26 / $3,801.89
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,089.30 / $4,073.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,905.46 / $3,019.95