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Vermont rates for HCPCS 21142

Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, without bone graft

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,737.80 / $3,467.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,949.84 / $3,162.28
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,949.84 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,949.84 / $3,388.44