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Wisconsin rates for HCPCS 21143

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

Facilitymedian $10,233 · 10th–90th $3,388–$16,9820%5%10%10th90th$10,233Professionalmedian $2,239 · 10th–90th $1,318–$6,4570%10%10th90th$2,239$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
$1,412.54 / $2,951.21 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,445.44 / $3,548.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,884.03 / $7,079.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,365.16 / $6,918.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $5,754.40 / $6,606.93
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $3,090.30 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,388.44 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $3,235.94 / $15,135.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,691.53 / $13,489.63
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,467.37 / $6,165.95
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,019.95 / $4,466.84
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $12,882.50 / $12,882.50
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $7,079.46 / $13,489.63
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,677.35 / $4,677.35 / $4,677.35
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $7,943.28 / $8,912.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,187.76 / $5,888.44