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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
$870.96 / $2,630.27 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,479.11 / $3,388.44
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $602.56 / $602.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $6,606.93 / $9,772.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $2,041.74 / $3,162.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,819.70 / $2,884.03
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $9,120.11 / $9,120.11
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,589.25 / $12,589.25 / $12,589.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $5,754.40 / $10,232.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,584.89 / $2,691.53