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Tennessee 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
$1,202.34 / $2,837.55 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,189.69 / $1,370.91 / $2,221.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,695.00 / $5,486.00 / $9,283.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,304.88 / $1,784.34 / $2,802.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,406.95 / $1,868.14 / $2,829.59
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $9,156.36 / $9,348.54
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,480.69 / $12,480.69 / $12,480.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,905.00 / $6,073.00 / $10,287.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,220.84 / $1,566.93 / $2,855.31