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Massachusetts rates for HCPCS 21146

Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $3,630.78 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,862.09 / $4,365.16
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $5,011.87 / $14,791.08
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $2,454.71 / $14,454.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $2,454.71 / $4,466.84
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $2,454.71 / $7,762.47
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,041.74 / $2,884.03
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $6,165.95 / $13,182.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,691.53 / $3,981.07
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $5,011.87 / $14,791.08
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $2,454.71 / $14,454.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $6,309.57 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $2,344.23 / $4,466.84