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North Carolina 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
$1,380.51 / $2,230.21 / $13,600.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.51 / $1,456.56 / $2,787.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,555.99 / $2,150.86 / $3,934.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.10 / $606.10 / $606.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,498.24 / $1,986.76 / $3,603.34
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.51 / $1,749.66 / $2,755.04
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,749.66 / $1,835.00 / $1,835.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $1,827.70 / $3,911.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,183.00 / $12,216.00 / $19,066.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,229.93 / $1,754.48 / $3,492.86
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $12,912.00 / $12,912.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,577.03 / $13,577.03 / $13,577.03