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New Hampshire rates for HCPCS 21256

Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)

Facilitymedian $4,169 · 10th–90th $2,399–$9,7720%20%10th90th$4,169Professionalmedian $1,778 · 10th–90th $1,202–$3,0900%10%10th90th$1,778$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
$1,905.46 / $4,168.69 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,412.54 / $2,511.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,623.41 / $9,120.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,398.83 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,995.26 / $3,715.35
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,862.09 / $2,818.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,905.46 / $3,715.35
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $891.25 / $1,479.11