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Idaho 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
$3,422.00 / $4,500.00 / $8,622.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,198.75 / $1,763.86 / $2,842.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,542.70 / $2,087.94 / $2,635.44
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,312.29 / $2,416.96 / $3,439.92
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,194.10 / $2,393.57 / $3,246.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $1,918.67 / $2,413.81
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,662.17 / $14,534.58 / $18,446.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,229.09 / $2,718.65 / $3,246.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $10,120.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,502.13 / $2,055.56 / $2,925.22