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New Mexico rates for HCPCS 21184

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 80 sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $2,507.98 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,234.65 / $2,507.98 / $7,850.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,396.78 / $3,622.69 / $4,454.97
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $3,850.65
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,234.65 / $3,147.28 / $5,573.84
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,453.79 / $3,803.38 / $6,075.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$899.00 / $11,259.00 / $16,897.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,656.03 / $3,543.68 / $5,089.50