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
Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)
SAN ANTONIO, TX
See all hospitals reporting CPT 21255 →Price type
Methodist Hospital’s median price of $6.5k is 6% above the median hospital's median price ($6.2k), higher than 57% of the 1,402 hospitals reporting CPT 21255. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 28 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | First Health chip per diem · outpatient | $365 | $365 | — | — | — | $365 – $365 |
| 2 | First Health chipperinate per diem · outpatient | $365 | $365 | — | — | — | $365 – $365 |
| 3 | First Health mcdstar per diem · outpatient | $365 | $365 | — | — | — | $365 – $365 |
| 4 | Aetna qhphix case rate · outpatient | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 5 | Aetna narrownetwork case rate · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 6 | Aetna newbusinessrates case rate · outpatient | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 7 | Aetna commercialbasenetwork case rate · outpatient | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 8 | Aetna oon case rate · outpatient | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 9 | WellCare mcrhmo fee schedule · outpatient | $6.1k | $6.1k | — | — | — | $6.1k – $6.1k |
| 10 | WellCare mcrpos fee schedule · outpatient | $6.1k | $6.1k | — | — | — | $6.1k – $6.1k |
| 11 | WellCare mcrppo fee schedule · outpatient | $6.1k | $6.1k | — | — | — | $6.1k – $6.1k |
| 12 | WellCare mcrsnp fee schedule · outpatient | $6.1k | $6.1k | — | — | — | $6.1k – $6.1k |
| 13 | WellCare pffs fee schedule · outpatient | $6.1k | $6.1k | — | — | — | $6.1k – $6.1k |
| 14 | Cigna newbusinessnetwork case rate · outpatient | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
| 15 | Cigna hmo case rate · outpatient | $7.0k | $7.0k | — | — | — | $7.0k – $7.0k |
| 16 | Cigna openaccessplus case rate · outpatient | $7.0k | $7.0k | — | — | — | $7.0k – $7.0k |
| 17 | Cigna ppo case rate · outpatient | $8.4k | $8.4k | — | — | — | $8.4k – $8.4k |
| 18 | UnitedHealthcare smallgroup case rate · outpatient | $9.2k | $9.2k | — | — | — | $9.2k – $9.2k |
| 19 | UnitedHealthcare charter case rate · outpatient | $9.7k | $9.7k | — | — | — | $9.7k – $9.7k |
| 20 | UnitedHealthcare nexusaco case rate · outpatient | $9.7k | $9.7k | — | — | — | $9.7k – $9.7k |
| 21 | Blue Cross Blue Shield mybluehealth fee schedule · outpatient | $9.7k | $9.7k | — | — | — | $9.7k – $9.7k |
| 22 | Blue Cross Blue Shield blueadvantage fee schedule · outpatient | $11.2k | $11.2k | — | — | — | $11.2k – $11.2k |
| 23 | UnitedHealthcare allpayerappendix case rate · outpatient | $11.5k | $11.5k | — | — | — | $11.5k – $11.5k |
| 24 | Healthcare Highways narrownetwork case rate · outpatient | $11.6k | $11.6k | — | — | — | $11.6k – $11.6k |
| 25 | Blue Cross Blue Shield blueessentials fee schedule · outpatient | $13.3k | $13.3k | — | — | — | $13.3k – $13.3k |
Last updated: May 1, 2026
See Cheekbone arch and jaw joint reconstruction with bone graft pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.