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Illinois rates for HCPCS 21255

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

Facilitymedian $3,802 · 10th–90th $1,259–$9,7720%5%10th90th$3,802Professionalmedian $1,585 · 10th–90th $1,202–$3,1620%10%10th90th$1,585$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
$1,202.26 / $3,548.13 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,513.56 / $2,951.21
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $9,120.11 / $28,840.32
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,137.96 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,862.09 / $2,884.03
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,187.76 / $6,025.60
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,659.59 / $1,778.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,348.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $5,370.32 / $12,302.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,621.81 / $2,818.38