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Wyoming rates for HCPCS 21275

Secondary revision of orbitocraniofacial reconstruction

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$846.21 / $854.95 / $1,080.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,006.39 / $5,006.39 / $5,006.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,620.00 / $1,944.00 / $2,941.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,137.56 / $1,706.34 / $2,348.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,188.00 / $5,188.00 / $18,767.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$914.28 / $1,699.54 / $2,823.60