go back

North Dakota 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
$1,445.60 / $1,445.60 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,347.48 / $1,430.84 / $1,445.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,785.93 / $3,064.67 / $3,593.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,746.62 / $3,489.53 / $4,648.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.60 / $1,713.15 / $2,457.52
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,481.84 / $2,629.67 / $3,765.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,481.84 / $2,622.86 / $3,260.05