go back

California rates for HCPCS 21143

Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, without bone graft

Facilitymedian $11,482 · 10th–90th $3,548$22,3870%5%10%10th90th$11,482Professionalmedian $1,778 · 10th–90th $1,288$6,0260%10%10th90th$1,778$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $8,912.51 / $22,387.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,659.59 / $7,413.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $13,489.63 / $22,387.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,089.30 / $4,265.80
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $4,073.80 / $7,079.46
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,995.26 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,778.28 / $3,801.89
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,479.11 / $1,995.26
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,584.89 / $3,981.07
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $16,982.44
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,125.38 / $14,125.38 / $14,125.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,778.28 / $2,951.21
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,778.28 / $3,715.35
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,677.35 / $4,677.35 / $4,677.35
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,659.59 / $2,398.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $11,748.98 / $25,118.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,513.56 / $3,311.31