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Tennessee rates for HCPCS 21255

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

Facilitymedian $3,981 · 10th–90th $1,096–$8,5110%10%10th90th$3,981Professionalmedian $1,585 · 10th–90th $1,202–$3,0900%10%20%10th90th$1,585$50.0$200.0$1.0K$5.0K$20.0K

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
$1,096.48 / $2,570.40 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,445.44 / $2,570.40
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $6,760.83 / $9,772.37
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,089.30 / $3,162.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,862.09 / $2,884.03
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $21,379.62 / $21,379.62
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,481.54 / $11,481.54 / $11,481.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $5,754.40 / $10,232.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,584.89 / $2,754.23