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Wyoming 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
$1,369.15 / $1,386.38 / $1,763.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,006.39 / $5,006.39 / $5,006.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,605.00 / $3,126.00 / $4,729.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,928.37 / $2,772.76 / $3,803.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,188.00 / $5,188.00 / $18,767.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,547.75 / $2,753.38 / $4,721.58