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New Mexico 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
$1,000.00 / $2,095.00 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,171.19 / $1,378.56 / $1,759.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,369.57 / $30,689.52 / $50,008.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,301.99 / $1,975.68 / $2,633.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $2,095.28
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,285.45 / $1,668.70 / $3,112.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,362.54 / $2,111.94 / $3,350.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$899.00 / $11,259.00 / $16,897.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,423.08 / $2,016.03 / $3,069.89