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Michigan rates for HCPCS 21143

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

Facilitymedian $4,898 · 10th–90th $1,778–$8,7100%50%10th90th$4,898Professionalmedian $1,622 · 10th–90th $1,288–$2,7540%20%10th90th$1,622$500.0$1.0K$2.0K$5.0K$10.0K$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
$1,778.28 / $4,897.79 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,445.44 / $2,884.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $2,089.30 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,737.80 / $2,454.71
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $4,466.84 / $6,918.31
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,737.80 / $3,162.28
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,737.80 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $7,762.47 / $14,791.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,659.59 / $2,290.87