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North Carolina 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
$1,304.45 / $4,637.00 / $8,442.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,191.90 / $1,379.58 / $2,625.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,525.90 / $2,577.83 / $3,624.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.10 / $606.10 / $606.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,443.29 / $1,879.75 / $3,400.89
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,304.45 / $1,687.81 / $2,683.32
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,687.81 / $1,702.00 / $1,717.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $1,729.60 / $3,708.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,183.00 / $12,216.00 / $19,066.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,179.81 / $1,735.01 / $3,599.93
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $9,156.36 / $9,156.36
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,480.69 / $12,480.69 / $12,480.69