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Alaska rates for HCPCS 21141

Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,236.00 / $9,774.00 / $14,772.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,191.90 / $1,393.50 / $6,602.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,333.64 / $4,479.75 / $5,736.26
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,247.29 / $6,602.47 / $9,243.45
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,239.50 / $3,887.40 / $7,891.82
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,932.50 / $6,615.12 / $7,950.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,247.29 / $6,602.47 / $9,243.45
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,004.71 / $6,538.20 / $8,626.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,769.38 / $5,406.54 / $7,884.36