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Tennessee 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
$1,350.97 / $3,329.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,281.98 / $1,553.62 / $2,435.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,830.00 / $5,467.00 / $9,283.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,402.17 / $1,909.62 / $3,021.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,570.95 / $2,058.44 / $3,194.60
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $13,835.20 / $14,127.84
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,972.78 / $15,972.78 / $15,972.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,372.00 / $6,090.00 / $12,183.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,309.80 / $1,768.00 / $3,272.35