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Utah 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
$2,187.76 / $6,025.60 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,949.84 / $8,128.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,995.26 / $3,311.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $2,818.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $9,772.37 / $21,379.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,691.53 / $3,981.07
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,754.23 / $3,715.35
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,454.71 / $3,548.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,548.82 / $2,454.71