go back

Georgia rates for HCPCS 21255

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $5,370.32 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,445.44 / $2,884.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $3,801.89 / $6,918.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,137.96 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $2,238.72 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,137.96 / $3,467.37
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,995.26 / $7,585.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $6,456.54 / $12,022.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,819.70 / $2,951.21