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Massachusetts rates for HCPCS 21180

Reconstruction, entire or majority of forehead and/or supraorbital rims; with autograft (includes obtaining grafts)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $3,715.35 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,905.46 / $4,466.84
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $5,011.87 / $15,488.17
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $2,570.40 / $17,782.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,570.40 / $4,677.35
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $2,398.83 / $8,511.38
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,089.30 / $2,884.03
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $6,165.95 / $13,182.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $2,754.23 / $4,073.80
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $5,011.87 / $15,488.17
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $2,570.40 / $17,782.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $6,309.57 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,511.89 / $4,677.35