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Utah 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
$2,344.23 / $6,025.60 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,137.96 / $9,120.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,238.72 / $3,630.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $3,019.95
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
$2,187.76 / $3,019.95 / $4,073.80
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $3,090.30 / $4,168.69
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,570.40 / $3,890.45
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
$1,380.38 / $1,737.80 / $2,754.23