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Pennsylvania rates for HCPCS 21256

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

Facilitymedian $5,370 · 10th–90th $1,202–$8,5110%10%20%10th90th$5,370Professionalmedian $1,288 · 10th–90th $1,096–$2,1880%20%40%10th90th$1,288$10.0$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
$1,047.13 / $5,370.32 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,258.93 / $1,949.84
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,288.25 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,445.44 / $2,454.71
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,778.28 / $2,290.87
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,445.44 / $2,041.74
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $3,981.07 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,258.93 / $2,754.23
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,905.46 / $2,630.27
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $1,202.26 / $1,513.56
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $1,202.26 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $5,754.40 / $19,054.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,380.38 / $2,511.89