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Pennsylvania 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

Facilitymedian $5,370 · 10th–90th $1,413–$8,5110%10%10th90th$5,370Professionalmedian $2,512 · 10th–90th $2,188–$4,3650%20%40%10th90th$2,512$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $5,370.32 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,511.89 / $4,168.69
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,570.40 / $4,570.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,951.21 / $4,897.79
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,388.44 / $4,365.16
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,818.38 / $3,981.07
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $4,265.80 / $8,511.38
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,454.71 / $3,981.07
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,388.44 / $4,677.35
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $2,630.27
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,454.71 / $2,570.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $5,754.40 / $19,054.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,818.38 / $5,011.87