go back

California 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
$3,715.35 / $9,549.93 / $23,442.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,659.59 / $5,888.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,918.31 / $11,748.98 / $18,620.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,344.23 / $4,677.35
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $100.00 / $6,456.54
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,041.74 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,949.84 / $4,168.69
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,621.81 / $2,187.76
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,737.80 / $3,715.35
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $56.23 / $14,125.38
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,803.84 / $13,803.84 / $13,803.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $2,187.76
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $1,905.46 / $3,235.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,995.26 / $4,073.80
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $5,128.61 / $5,128.61
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,479.11 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $12,302.69 / $25,703.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,621.81 / $3,467.37