go back

Maine 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
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,691.53 / $6,025.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $3,388.44 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $3,311.31 / $5,128.61
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $3,019.95 / $5,623.41
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,235.94 / $6,309.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $3,019.95 / $4,570.88