go back

Massachusetts 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
$1,348.96 / $3,388.44 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,584.89 / $3,715.35
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $4,570.88 / $13,489.63
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,089.30 / $13,182.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,089.30 / $3,801.89
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $2,089.30 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,737.80 / $2,454.71
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $6,165.95 / $13,182.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $2,290.87 / $3,548.13
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $4,570.88 / $13,489.63
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,089.30 / $13,182.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $6,309.57 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,041.74 / $3,890.45