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Iowa rates for HCPCS 21255

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

Facilitymedian $4,786 · 10th–90th $2,138–$12,5890%5%10%10th90th$4,786Professionalmedian $1,585 · 10th–90th $1,230–$3,5480%10%20%10th90th$1,585$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$2,137.96 / $4,786.30 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,479.11 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,162.28 / $3,890.45
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,862.09 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,467.37 / $14,454.40
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,630.27 / $10,964.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,235.94 / $3,548.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,754.23 / $3,548.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $10,964.78 / $15,488.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,995.26 / $3,890.45
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,570.40 / $3,019.95