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Rhode Island rates for HCPCS 21255

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

Facilitymedian $3,981 · 10th–90th $3,020–$12,5890%10%10th90th$3,981Professionalmedian $1,445 · 10th–90th $1,122–$2,9510%20%40%10th90th$1,445$1.0K$2.0K$5.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,715.35 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,230.27 / $2,951.21
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,584.89 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,949.84 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $7,413.10 / $13,182.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,698.24 / $3,019.95