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Pennsylvania rates for HCPCS 21145

Rcnstj Midface Lefort I 1 Piece W/Bone Grafts

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,426.00 / $3,839.00 / $8,261.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,328.43 / $1,535.97 / $1,991.92
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,538.99 / $1,597.07 / $2,928.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,738.56 / $1,738.56 / $1,738.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,439.81 / $1,886.98 / $3,089.75
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,794.46 / $2,380.10 / $3,099.53
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32,866.33 / $32,866.33 / $32,866.33
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,283.00 / $4,761.00 / $8,451.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,373.91 / $1,567.67 / $5,100.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,514.60 / $1,514.60 / $3,156.40
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,738.56 / $1,738.56 / $1,738.56
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,443.11 / $1,906.00 / $3,089.75
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.79 / $1,513.79 / $1,542.21
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,476.29 / $1,513.79 / $1,595.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,332.00 / $3,879.00 / $7,508.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,357.62 / $1,833.56 / $2,914.82