go back

North Carolina rates for HCPCS 21255

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

Facilitymedian $2,399 · 10th–90th $1,318–$10,4710%10%10th90th$2,399Professionalmedian $1,585 · 10th–90th $1,230–$3,7150%10%20%10th90th$1,585$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
$1,659.59 / $5,248.07 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,445.44 / $2,754.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $6,165.95 / $8,709.64
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,778.28 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,862.09 / $3,019.95
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $3,090.30
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,778.28 / $2,884.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,344.23 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $11,748.98 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,513.56 / $2,884.03
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $21,379.62 / $21,379.62
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,481.54 / $11,481.54 / $11,481.54