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Washington, DC rates for HCPCS 21255

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

Facilitymedian $5,129 · 10th–90th $1,413–$7,7620%10%10th90th$5,129Professionalmedian $1,380 · 10th–90th $1,230–$3,1620%20%10th90th$1,380$1.0K$2.0K$5.0K$10.0K$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
$1,380.38 / $5,128.61 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,380.38 / $2,951.21
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $4,365.16 / $10,715.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,698.24 / $3,715.35
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,884.03 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $13,182.57 / $33,113.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,737.80 / $3,715.35