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California rates for HCPCS 21255

Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)

Facilitymedian $10,471 · 10th–90th $3,388$17,7830%5%10%10th90th$10,471Professionalmedian $1,698 · 10th–90th $1,230$5,6230%10%10th90th$1,698$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
$3,548.13 / $8,912.51 / $21,379.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,479.11 / $6,165.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $11,481.54 / $17,782.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,041.74 / $4,168.69
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $5,495.41 / $9,332.54
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,995.26 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,737.80 / $3,715.35
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,445.44 / $1,949.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,513.56 / $2,951.21
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $21,379.62
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,481.54 / $11,481.54 / $11,481.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,737.80 / $2,754.23
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,737.80 / $3,548.13
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $4,570.88
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,621.81 / $2,398.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $11,748.98 / $25,118.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,445.44 / $3,235.94