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Florida rates for HCPCS 21143

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.24 / $5,182.00 / $11,576.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,209.81 / $1,382.98 / $1,854.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.00 / $400.00 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,155.57 / $1,773.28 / $2,944.18
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,139.00 / $12,804.00 / $23,031.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.25 / $1,289.02 / $1,521.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.24 / $1,015.20 / $1,757.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,581.00 / $10,309.00 / $15,888.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,078.59 / $1,474.51 / $2,698.35
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,081.81 / $1,081.81 / $1,299.79