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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
$1,698.24 / $5,248.07 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,513.56 / $3,630.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,754.23 / $2,754.23 / $2,754.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,862.09 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,905.46 / $3,467.37
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $3,235.94
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,819.70 / $2,884.03
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,398.83 / $3,090.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $11,748.98 / $18,620.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,548.82 / $3,019.95
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $12,882.50 / $12,882.50
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,489.63 / $13,489.63 / $13,489.63