go back

Utah 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
$1,967.87 / $4,387.00 / $8,344.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,171.19 / $1,399.83 / $7,326.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,455.38 / $1,935.20 / $3,174.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.95 / $808.29 / $1,280.50
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,238.37 / $11,103.62 / $16,181.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,774.98 / $2,335.40 / $3,634.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $7,693.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.89 / $1,502.13 / $2,282.41