go back

Alaska rates for HCPCS 21145

Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,556.30 / $9,774.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,328.43 / $1,537.04 / $7,727.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,906.05 / $5,266.50 / $6,662.66
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,451.88 / $7,727.65 / $10,818.71
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,763.53 / $4,516.22 / $9,168.37
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,780.00 / $7,727.96 / $9,448.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,451.88 / $7,727.65 / $10,818.71
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,346.46 / $7,627.95 / $10,124.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,213.20 / $7,373.10 / $9,269.04