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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
$3,890.45 / $6,760.83 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,445.44 / $4,168.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $15,848.93 / $16,595.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,754.23 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,511.89 / $3,630.78
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,995.26 / $2,511.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $10,232.93 / $16,218.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,995.26 / $3,715.35