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Michigan 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
$2,951.21 / $4,897.79 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,344.23 / $4,265.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $3,467.37 / $3,467.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $3,467.37 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,691.53 / $6,456.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $4,897.79 / $7,079.46
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,630.27 / $3,630.78
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,511.89 / $4,168.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $7,943.28 / $14,791.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,754.23 / $3,630.78