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Mississippi rates for HCPCS 21255

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $1,819.70 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,318.26 / $2,570.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,137.96 / $2,818.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $4,168.69 / $11,748.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,548.82 / $3,090.30