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Oregon rates for HCPCS 21255

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

Facilitymedian $2,630 · 10th–90th $1,738–$13,8040%20%40%10th90th$2,630Professionalmedian $2,188 · 10th–90th $1,230–$3,7150%10%20%10th90th$2,188$20.0$200.0$2.0K$20.0K$200.0K

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
$2,754.23 / $3,467.37 / $13,803.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,445.44 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,570.40 / $3,630.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,630.27 / $3,235.94
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,238.72 / $3,311.31
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,454.71 / $3,467.37
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,630.27 / $2,691.53
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,238.72 / $3,235.94
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $2,570.40 / $3,630.78
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $18,620.87 / $24,547.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,090.30 / $4,073.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $17,782.79 / $25,703.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,570.40 / $3,548.13