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Wisconsin rates for HCPCS 21256

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

Facilitymedian $10,233 · 10th–90th $3,162–$16,9820%5%10%10th90th$10,233Professionalmedian $1,778 · 10th–90th $1,122–$5,4950%20%10th90th$1,778$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
$1,202.26 / $2,511.89 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,230.27 / $3,090.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,511.89 / $6,456.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,715.35 / $5,888.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $5,011.87 / $5,623.41
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,570.40 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,951.21 / $3,801.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,818.38 / $15,135.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,238.72 / $14,791.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,884.03 / $5,128.61
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,691.53 / $3,890.45
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $13,803.84 / $13,803.84
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $7,413.10 / $14,791.08
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $7,762.47 / $8,511.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,862.09 / $5,011.87