go back

Nebraska rates for HCPCS 21143

Rcnstj Midface Lefort I 3/> Piece W/O Bone Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,241.22 / $9,544.15 / $20,928.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,317.22 / $1,317.22 / $6,997.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,086.90 / $11,951.75 / $23,118.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,261.32 / $2,149.98 / $2,866.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,266.02 / $3,221.58 / $4,337.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,317.22 / $2,305.14 / $8,757.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,783.15 / $2,919.29 / $4,024.61
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,720.81 / $3,093.50 / $4,386.54
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,230.17 / $2,917.36 / $4,337.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,178.00 / $7,441.00 / $8,816.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,783.15 / $2,919.29 / $3,618.41