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Idaho rates for HCPCS 21263

Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $5,519.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,272.13 / $2,910.69 / $4,579.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,376.51 / $3,395.00 / $3,990.84
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.31 / $3,725.68 / $5,495.75
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,606.87 / $3,934.76 / $5,227.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $3,092.73 / $3,890.85
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,660.78 / $14,097.25 / $17,807.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,245.25 / $4,473.55 / $5,227.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $10,120.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,043.51 / $3,125.66 / $4,538.13