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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
$2,041.74 / $10,000.00 / $41,686.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,698.24 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,311.31 / $4,466.84 / $5,754.40
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $2,041.74 / $9,332.54
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,884.03 / $3,890.45 / $6,760.83
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.80 / $5,370.32 / $7,762.47
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $2,041.74 / $7,244.36
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $1,862.09 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $6,165.95 / $7,943.28