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Missouri rates for HCPCS 21255

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

Facilitymedian $4,266 · 10th–90th $1,778–$8,5110%10%10th90th$4,266Professionalmedian $1,549 · 10th–90th $1,202–$3,0900%10%10th90th$1,549$100.0$500.0$2.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $4,466.84 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,445.44 / $3,388.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,570.88 / $8,912.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,659.59 / $2,570.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,479.11 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,778.28 / $2,884.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,949.84 / $6,918.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,949.84 / $10,964.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,715.35 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,621.81 / $2,398.83