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Washington 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 $5,623 · 10th–90th $2,754–$19,4980%10%10th90th$5,623Professionalmedian $3,388 · 10th–90th $2,188–$6,3100%10%20%10th90th$3,388$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
$4,570.88 / $8,128.31 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,818.38 / $6,165.95
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,481.54 / $14,791.08 / $28,840.32
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,786.30 / $6,760.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,981.07 / $7,413.10
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $4,677.35 / $9,120.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $4,466.84 / $7,079.46
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $158.49
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,677.35 / $5,248.07
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $3,388.44
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,897.79 / $6,456.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,471.29 / $14,791.08 / $28,840.32
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,786.30 / $6,606.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $17,378.01 / $33,884.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,548.13 / $6,456.54
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,454.71 / $4,466.84