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Illinois rates for HCPCS 21268

Orbital Repositioning W/Bone Grafts Icra & Xtrc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,129.00 / $3,221.00 / $5,580.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,686.07 / $2,032.05 / $3,829.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,401.35 / $26,526.96 / $53,120.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $875.00 / $908.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,664.73 / $2,794.46 / $4,084.21
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,083.67 / $3,288.87 / $7,350.80
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,355.46 / $2,520.46 / $2,794.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $3,159.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $5,619.00 / $12,241.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,825.46 / $2,394.06 / $4,491.66