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Tennessee 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
$1,096.48 / $2,570.40 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,398.83 / $5,011.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $6,606.93 / $9,772.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $3,467.37 / $5,370.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,162.28 / $4,897.79
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $20,892.96 / $20,892.96
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21,379.62 / $21,379.62 / $21,379.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $5,754.40 / $10,232.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,691.53 / $4,570.88