go back

Pennsylvania rates for HCPCS 21143

Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, without bone graft

Facilitymedian $5,370 · 10th–90th $1,445–$8,5110%10%10th90th$5,370Professionalmedian $1,445 · 10th–90th $1,259–$3,0900%50%10th90th$1,445$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $5,370.32 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,445.44 / $3,548.13
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,445.44 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,659.59 / $2,818.38
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,041.74 / $2,630.27
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,659.59 / $2,344.23
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23,988.33 / $23,988.33 / $23,988.33
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $4,168.69 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,445.44 / $3,801.89
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,137.96 / $3,090.30
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $1,445.44
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,348.96 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $5,754.40 / $19,054.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,584.89 / $2,818.38