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Maine rates for HCPCS 21255

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

Facilitymedian $12,023 · 10th–90th $12,023–$12,0230%50%100%$12,023Professionalmedian $1,660 · 10th–90th $1,230–$3,3880%10%20%10th90th$1,660$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,584.89 / $3,388.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,949.84 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,995.26 / $3,019.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,819.70 / $3,388.44
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,548.82 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $12,022.64 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,737.80 / $2,691.53