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Utah rates for HCPCS 21263

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

Facilitymedian $4,467 · 10th–90th $2,692–$11,4820%20%10th90th$4,467Professionalmedian $2,754 · 10th–90th $2,042–$12,3030%10%10th90th$2,754$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
$2,691.53 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,691.53 / $13,803.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,691.53 / $4,677.35
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $3,801.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $11,481.54 / $17,782.79
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,630.78 / $5,011.87
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $4,073.80 / $5,495.41
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,235.94 / $4,897.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,238.72 / $3,548.13