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Minnesota rates for HCPCS 21255

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

Facilitymedian $8,511 · 10th–90th $1,622–$21,3800%10%10th90th$8,511Professionalmedian $2,884 · 10th–90th $1,349–$4,7860%10%10th90th$2,884$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
$1,348.96 / $1,348.96 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,380.38 / $2,187.76
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,762.47 / $13,803.84 / $31,622.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,311.31 / $4,786.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,897.79 / $11,748.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,981.07 / $5,888.44
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,677.35 / $9,332.54
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,311.31 / $5,370.32
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,630.27 / $9,772.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,630.27 / $7,762.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $6,760.83 / $15,135.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,630.27 / $4,897.79