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Washington rates for HCPCS 21143

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

Facilitymedian $3,631 · 10th–90th $1,778–$19,9530%10%10th90th$3,631Professionalmedian $2,089 · 10th–90th $1,288–$3,8020%10%20%10th90th$2,089$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
$2,630.27 / $9,332.54 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,819.70 / $3,548.13
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,128.31 / $15,488.17 / $31,622.78
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,691.53 / $3,801.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,344.23 / $4,265.80
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,951.21 / $7,079.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,884.03 / $5,370.32
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $91.20
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,754.23 / $2,818.38
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,818.38 / $3,715.35
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,715.19 / $16,218.10 / $31,622.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,691.53 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $17,378.01 / $33,884.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,041.74 / $3,715.35
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,479.11 / $2,691.53