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Minnesota 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
$1,380.38 / $1,380.38 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,412.54 / $2,884.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,762.47 / $13,803.84 / $30,902.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $3,235.94 / $4,897.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $5,011.87 / $12,022.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $4,073.80 / $6,025.60
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $4,786.30 / $9,332.54
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $3,388.44 / $5,495.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $2,818.38 / $9,772.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,630.27 / $7,762.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $5,754.40 / $12,589.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,570.40 / $4,897.79