go back

Maine rates for HCPCS 21260

Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.98 / $1,452.60 / $1,762.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,437.34 / $1,860.08 / $2,606.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,394.03 / $2,089.65 / $2,974.33
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,700.74 / $1,967.76 / $3,018.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.98 / $1,584.01 / $1,762.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.99 / $1,948.06 / $2,722.28