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Oklahoma 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
$1,412.54 / $3,890.45 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,380.38 / $2,630.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,912.51 / $13,803.84 / $22,387.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,584.89 / $1,778.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,778.28 / $2,238.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $2,137.96 / $8,709.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,513.56 / $12,589.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $5,754.40 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,380.38 / $1,862.09