go back

West Virginia 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
$1,285.67 / $1,400.00 / $2,300.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,191.90 / $1,379.58 / $2,044.40
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,274.86 / $1,396.05 / $1,666.79
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$760.13 / $1,481.59 / $1,481.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,491.55 / $1,491.55 / $1,491.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,274.01 / $1,887.30 / $3,850.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,036.97 / $1,521.10 / $2,193.38