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Minnesota 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
$1,445.44 / $1,445.44 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,445.44 / $2,951.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,943.28 / $13,803.84 / $32,359.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $3,311.31 / $5,128.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $5,128.61 / $12,302.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $4,168.69 / $6,309.57
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $4,897.79 / $9,772.37
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $3,548.13 / $5,623.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $2,884.03 / $9,772.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,754.23 / $7,943.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $5,754.40 / $12,589.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,630.27 / $5,128.61