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Maryland 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
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,659.59 / $4,570.88
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,862.09 / $2,290.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,995.26 / $3,630.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,698.24 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $1,174.90 / $2,884.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,819.70 / $3,311.31
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,819.70 / $2,344.23