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Idaho rates for HCPCS 21255

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

Facilitymedian $3,981 · 10th–90th $1,549–$15,1360%10%10th90th$3,981Professionalmedian $2,089 · 10th–90th $1,288–$2,8180%10%20%10th90th$2,089$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
$3,388.44 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,778.28 / $2,754.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $6,606.93 / $15,135.61
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,570.40 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,778.28 / $2,454.71
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,041.74 / $3,467.37
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,290.87 / $3,019.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $13,182.57 / $18,620.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,630.27 / $2,818.38
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,380.38 / $9,332.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $12,022.64 / $27,542.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,995.26 / $2,884.03