CPT 21255
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Reconstruct lower jaw bone
Low
$965
Average
$5.4k
Median
$5.0k
High
$17.6k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
60 payers; the 90th percentile is 4.0× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna fee schedule · outpatient · +6 other terms | 414 | $6.3k | $7.5k | $5.3k | 71% | — | $79 – $48.0k |
| 2 | UnitedHealthcare fee schedule · outpatient · +6 other terms | 387 | $6.2k | $8.0k | $8.3k | 103% | — | $196 – $173.8k |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +6 other terms | 311 | $7.8k | $13.6k | $10.3k | 76% | — | $0 – $49.7k |
| 4 | Humana fee schedule · outpatient · +6 other terms | 285 | $6.0k | $6.0k | $2.1k | 35% | — | $1.1k – $17.1k |
| 5 | Cigna fee schedule · outpatient · +6 other terms | 192 | $5.9k | $7.0k | $5.4k | 77% | — | $0 – $30.6k |
| 6 | WellCare fee schedule · outpatient · +6 other terms | 131 | $6.1k | $6.5k | $2.1k | 31% | — | $223 – $13.9k |
| 7 | Molina fee schedule · outpatient · +5 other terms | 126 | $6.2k | $6.3k | $3.4k | 54% | — | $177 – $13.7k |
| 8 | Anthem fee schedule · outpatient · +4 other terms | 122 | $5.8k | $6.3k | $7.1k | 113% | — | $1.3k – $43.3k |
| 9 | Kaiser fee schedule · outpatient · +4 other terms | 94 | $7.5k | $9.4k | $7.2k | 77% | — | $1.2k – $42.0k |
| 10 | Devoted fee schedule · outpatient · +4 other terms | 68 | $6.0k | $5.5k | $1.5k | 28% | — | $1.3k – $6.7k |
| 11 | Ambetter facility · fee schedule · outpatient · +4 other terms | 57 | $10.1k | $10.1k | $2.6k | 26% | — | $1.9k – $14.3k |
| 12 | Oscar fee schedule · outpatient · +3 other terms | 39 | $9.5k | $6.6k | $5.3k | 80% | — | $1 – $16.9k |
| 13 | Optum fee schedule · outpatient · +4 other terms | 35 | $5.7k | $6.7k | $5.1k | 76% | — | $1.3k – $21.9k |
| 14 | Bcbs Tx fee schedule · outpatient · +1 other terms | 32 | $2.8k | $2.8k | $1.5k | 53% | — | $1.1k – $6.1k |
| 15 | Caresource facility · fee schedule · outpatient · +4 other terms | 31 | $9.1k | $8.5k | $2.7k | 32% | — | $1.3k – $13.1k |
| 16 | Clover fee schedule · outpatient · +3 other terms | 31 | $6.5k | $6.3k | $402 | 6% | — | $5.3k – $7.0k |
| 17 | Medicare fee schedule · outpatient · +5 other terms | 24 | $1.3k | $2.2k | $1.9k | 83% | — | $1.2k – $5.9k |
| 18 | Medica fee schedule · outpatient · +4 other terms | 23 | $2.6k | $3.4k | $1.7k | 50% | — | $1.1k – $6.2k |
| 19 | Regence professional · fee schedule · outpatient · +2 other terms | 20 | $1.0k | $1.0k | $738 | 71% | — | $207 – $2.7k |
| 20 | First Health fee schedule · outpatient · +2 other terms | 19 | $6.3k | $9.2k | $4.8k | 53% | — | $1.3k – $16.3k |
| 21 | Medical Mutual fee schedule · outpatient · +1 other terms | 17 | $13.7k | $12.8k | $4.6k | 36% | — | $5.1k – $24.9k |
| 22 | Tricare fee schedule · outpatient · +3 other terms | 17 | $5.8k | $16.2k | $18.9k | 117% | — | $5.4k – $50k |
| 23 | Amerihealth Caritas fee schedule · both · +3 other terms | 16 | $1.1k | $2.8k | $2.2k | 78% | — | $1.1k – $6.3k |
| 24 | Highmark fee schedule · outpatient · +5 other terms | 16 | $5.6k | $5.6k | $3.8k | 69% | — | $800 – $17.4k |
| 25 | MultiPlan fee schedule · outpatient · +4 other terms | 15 | $9.4k | $9.4k | $273 | 3% | — | $5.6k – $9.4k |
← Hospitals reporting CPT 21255 · Snapshot 20261113T090226Z-3ce6c0b8