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New York 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
$2,167.13 / $4,640.82 / $10,674.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,201.79 / $2,575.44 / $4,693.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,079.00 / $7,359.00 / $12,869.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,047.53 / $2,676.52 / $5,673.73
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,496.07 / $3,496.07 / $37,499.62
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,496.07 / $3,496.07 / $3,496.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,789.24 / $2,789.24 / $2,789.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,417.53 / $3,956.73 / $9,189.07
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $3,646.00 / $6,489.25
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,889.04 / $3,851.66 / $5,566.33
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,300.21 / $2,300.21 / $2,300.21
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,840.18 / $2,935.81 / $5,178.85
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $597.00 / $2,789.24
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,542.35 / $3,774.39 / $8,688.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,264.00 / $5,963.00 / $14,457.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,234.84 / $3,104.06 / $7,866.80
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,935.81 / $2,935.81 / $11,595.07
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,996.35 / $3,205.58 / $6,205.84