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Connecticut 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
$3,522.00 / $7,372.86 / $10,492.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,198.75 / $1,449.31 / $3,390.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,936.00 / $22,514.00 / $29,306.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,214.95 / $2,638.28 / $3,682.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$843.00 / $843.00 / $843.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,803.56 / $2,459.46 / $3,512.44
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,346.67 / $2,466.00 / $2,518.00
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,164.64 / $1,979.04 / $2,502.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,644.00 / $8,468.00 / $13,943.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,220.05 / $2,379.09 / $4,092.14