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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
$3,388.44 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,513.56 / $2,818.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $7,079.46 / $15,135.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,691.53 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,949.84 / $2,454.71
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $2,238.72 / $3,630.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,290.87 / $3,090.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $13,182.57 / $18,620.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,630.27 / $2,884.03
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,258.93 / $10,964.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $10,232.93 / $27,542.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,041.74 / $2,884.03