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Kentucky rates for HCPCS 21255

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

Facilitymedian $8,128 · 10th–90th $851–$10,7150%10%20%10th90th$8,128Professionalmedian $1,349 · 10th–90th $1,122–$2,3440%20%10th90th$1,349$50.0$200.0$1.0K$5.0K

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
$794.33 / $3,235.94 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,348.96 / $2,344.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $10,715.19 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,318.26 / $1,778.28
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,621.81 / $2,137.96
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,584.89 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $2,238.72 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,089.30 / $7,079.46
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $6,025.60 / $10,471.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,621.81 / $2,691.53