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Nebraska 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
$4,241.22 / $10,431.19 / $20,928.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,512.32 / $1,512.32 / $8,062.97
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,086.90 / $11,951.75 / $23,118.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,447.29 / $2,466.96 / $3,289.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,480.62 / $3,690.60 / $4,980.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,512.32 / $2,646.56 / $7,441.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,037.70 / $3,370.04 / $4,664.55
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,958.11 / $3,537.81 / $4,990.51
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,506.73 / $3,470.16 / $4,980.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,178.00 / $7,441.00 / $8,816.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,037.70 / $3,479.76 / $4,388.89