go back

Maryland rates for HCPCS 21142

Rcnstj Midface Lefort I 2 Pieces W/O Bone Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,889.41 / $13,889.41 / $13,889.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,198.75 / $1,367.19 / $1,585.97
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,500.29 / $1,666.99 / $1,833.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.00 / $507.00 / $641.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,219.63 / $1,780.13 / $3,124.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,410.91 / $1,820.07 / $2,391.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.00 / $847.00 / $1,560.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,084.08 / $1,602.12 / $3,061.14
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,236.52 / $1,622.55 / $2,018.31