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
$1.2k
Average
$4.5k
Median
$3.7k
High
$13.7k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
14 payers; the 90th percentile is 5.5× 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.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Humana other · outpatient · +2 other terms | 41 | $2.8k | $2.8k | $1.5k | 53% | — | $969 – $7.0k |
| 2 | Tricare other · outpatient · +1 other terms | 13 | $5.4k | $4.4k | $1.5k | 33% | — | $2.1k – $5.8k |
| 3 | Oscar other · both · +1 other terms | 10 | $1k | $1k | — | — | — | $1k – $1k |
| 4 | Cigna other · outpatient | 7 | $7.5k | $6.0k | $2.9k | 49% | — | $1.3k – $8.7k |
| 5 | Aetna other · both · +2 other terms | 5 | $1.5k | $1.6k | $256 | 16% | — | $1.5k – $2.2k |
| 6 | Caresource other · outpatient · +1 other terms | 5 | $6.5k | $7.4k | $1.6k | 21% | — | $5.8k – $9.4k |
| 7 | Molina facility · other · outpatient | 5 | $5.1k | $6.4k | $2.6k | 41% | — | $4.3k – $11.2k |
| 8 | UnitedHealthcare facility · other · outpatient · +2 other terms | 4 | $6.0k | $6.0k | $670 | 11% | — | $5.1k – $7.0k |
| 9 | Blue Cross Blue Shield other · both · +2 other terms | 3 | $2.4k | $2.4k | $147 | 6% | — | $2.3k – $2.9k |
| 10 | First Health other · outpatient | 3 | $2.4k | $2.3k | $116 | 5% | — | $2.2k – $2.4k |
| 11 | Anthem facility · other · outpatient · +1 other terms | 2 | $6.1k | $6.1k | $894 | 15% | — | $5.2k – $7.0k |
| 12 | Bcbs Al other · outpatient | 1 | $13.7k | $13.7k | — | — | — | $13.7k – $13.7k |
| 13 | Bcbs Nv other · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 14 | Medicare professional · other · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
← Hospitals reporting CPT 21255 · Snapshot 20261113T090226Z-3ce6c0b8