go back

South Carolina rates for HCPCS 21256

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $7,943.28 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,258.93 / $2,630.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $7,943.28 / $16,595.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,513.56 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,659.59 / $3,235.94
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $2,818.38
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,584.89 / $2,754.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $17,378.01 / $26,302.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,258.93 / $2,089.30