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Arizona rates for HCPCS 21183

Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 40 sq cm but less than 80 sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $4,474.00 / $7,960.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,921.58 / $2,169.50 / $12,165.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,640.00 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,376.64 / $2,716.16 / $3,395.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,991.58 / $2,725.33 / $4,449.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,182.46 / $2,912.55 / $7,168.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,004.98 / $2,539.15 / $21,431.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,150.00 / $6,486.00 / $9,010.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,954.05 / $2,351.65 / $4,615.26