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Georgia rates for HCPCS 21255

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

Facilitymedian $5,129 · 10th–90th $1,820–$8,3180%10%10th90th$5,129Professionalmedian $1,622 · 10th–90th $1,230–$2,8840%10%10th90th$1,622$100.0$500.0$2.0K$10.0K

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
$2,344.23 / $5,370.32 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,479.11 / $2,884.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $4,073.80 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,137.96 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,137.96 / $3,467.37
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,737.80 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $6,309.57 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,819.70 / $2,951.21