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Wisconsin 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 $10,233 · 10th–90th $5,012–$16,9820%10%10th90th$10,233Professionalmedian $3,548 · 10th–90th $2,239–$10,4710%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
$2,398.83 / $5,011.87 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,454.71 / $6,165.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,897.79 / $12,302.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $7,413.10 / $11,748.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $9,772.37 / $11,220.18
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $5,011.87 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $5,754.40 / $7,413.10
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $5,011.87 / $13,489.63
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $4,466.84 / $23,442.29
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $5,495.41 / $10,232.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,128.61 / $7,585.78
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $22,387.21 / $22,387.21
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $12,022.64 / $23,442.29
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,943.28 / $7,943.28 / $7,943.28
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,606.93 / $13,489.63 / $15,488.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,715.35 / $10,000.00