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Oklahoma 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
$1,438.44 / $4,195.00 / $13,200.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,198.75 / $1,438.44 / $1,438.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,334.45 / $14,829.12 / $23,429.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $900.00 / $900.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,436.26 / $1,817.37 / $2,175.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,362.76 / $1,973.78 / $8,753.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,194.72 / $1,534.84 / $13,111.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,481.00 / $5,910.00 / $9,232.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,141.30 / $1,446.25 / $2,137.17