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Utah 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 $6,026 · 10th–90th $3,162–$10,2330%10%10th90th$6,026Professionalmedian $3,548 · 10th–90th $2,239–$13,1830%10%20%10th90th$3,548$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
$3,162.28 / $6,025.60 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,548.13 / $14,791.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,311.31 / $5,248.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $4,168.69
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $10,471.29 / $15,135.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,073.80 / $6,309.57
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $4,570.88 / $6,025.60
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,548.13 / $5,128.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,570.40 / $4,168.69