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Delaware 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
$3,513.67 / $3,513.67 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,198.75 / $1,222.01 / $1,399.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,194.66 / $1,455.93 / $2,594.38
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,581.50 / $12,581.50 / $12,581.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,530.00 / $2,530.00 / $2,530.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,087.33 / $1,398.39 / $3,127.14