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Florida rates for HCPCS 21255

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

Facilitymedian $6,457 · 10th–90th $1,445–$13,1830%10%10th90th$6,457Professionalmedian $1,413 · 10th–90th $1,122–$2,2910%20%10th90th$1,413$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
$1,258.93 / $5,495.41 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,412.54 / $2,187.76
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $6,165.95 / $12,882.50
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,380.38 / $1,548.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $398.11 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,698.24 / $2,754.23
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $13,489.63 / $23,988.33
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,000.00 / $1,380.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $9,549.93 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,412.54 / $2,630.27
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,348.96