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Arizona rates for HCPCS 21142

Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, without bone graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $4,474.00 / $7,960.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,171.19 / $1,272.57 / $2,713.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,310.70 / $4,934.39 / $8,070.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,418.04 / $1,620.62 / $2,025.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,182.97 / $1,600.48 / $2,769.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.56 / $1,763.86 / $7,168.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,167.33 / $1,485.54 / $13,111.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,613.00 / $6,455.00 / $9,010.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,141.30 / $1,423.08 / $2,669.60