go back

New Hampshire rates for HCPCS 21263

Periorbital Osteotomies W/Bone Grafts W/Forehead

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $3,742.21 / $7,234.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,757.39 / $2,027.54 / $2,921.39
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,769.10 / $5,299.00 / $8,600.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,185.98 / $3,743.90 / $5,587.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,513.88 / $2,513.88 / $2,513.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,772.89 / $4,234.39 / $6,615.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,502.48 / $4,105.59 / $7,723.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,155.00 / $11,155.00 / $11,155.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,414.87 / $3,743.05 / $7,791.36
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,805.49 / $1,986.04 / $2,527.69