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Wisconsin rates for HCPCS 21275

Secondary revision of orbitocraniofacial reconstruction

Facilitymedian $10,233 · 10th–90th $2,884–$16,9820%5%10%10th90th$10,233Professionalmedian $1,230 · 10th–90th $776–$3,7150%10%20%10th90th$1,230$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
$812.83 / $5,370.32 / $13,489.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $851.14 / $2,089.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,698.24 / $4,570.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,570.40 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $3,388.44 / $3,890.45
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,778.28 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,995.26 / $2,570.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,905.46 / $15,135.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,548.82 / $14,791.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,995.26 / $3,467.37
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,819.70 / $2,691.53
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,125.38 / $20,892.96 / $20,892.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $4,073.80 / $14,791.08
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $4,677.35 / $5,248.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,258.93 / $3,467.37