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Idaho 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
$3,388.44 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,659.59 / $3,235.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $6,309.57 / $9,549.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $2,951.21 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,187.76 / $2,818.38
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $2,511.89 / $3,981.07
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,570.40 / $3,467.37
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $7,585.78 / $10,232.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,951.21 / $3,235.94
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,412.54 / $3,630.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $10,232.93 / $27,542.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $2,290.87 / $3,162.28