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Vermont 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
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,778.28 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,949.84 / $3,235.94
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,995.26 / $2,344.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,041.74 / $3,467.37