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Wisconsin rates for HCPCS 21145

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

Facilitymedian $10,233 · 10th–90th $3,548$16,9820%5%10%10th90th$10,233Professionalmedian $2,291 · 10th–90th $1,445$6,9180%20%10th90th$2,291$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
$1,548.82 / $3,235.94 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,548.82 / $4,677.35
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
$1,584.89 / $3,162.28 / $8,128.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,786.30 / $7,585.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $6,309.57 / $7,244.36
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,235.94 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,715.35 / $4,786.30
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,235.94 / $13,489.63
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,818.38 / $13,803.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,630.78 / $6,606.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,311.31 / $4,897.79
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $14,125.38 / $14,125.38
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $7,585.78 / $13,803.84
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $5,128.61
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $8,709.64 / $10,000.00
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
$1,548.82 / $2,398.83 / $6,309.57