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Illinois 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
$1,258.93 / $3,548.13 / $10,000.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,445.44 / $3,162.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,585.78 / $10,232.93 / $114,815.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,709.64 / $8,709.64 / $8,709.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,905.46 / $2,818.38
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $2,290.87 / $9,772.37
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,698.24 / $1,862.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $5,370.32 / $12,302.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,659.59 / $2,884.03