go back

Wisconsin 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)

Facilitymedian $10,000 · 10th–90th $3,981–$16,9820%5%10%10th90th$10,000Professionalmedian $2,399 · 10th–90th $1,514–$7,2440%10%20%10th90th$2,399$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
$1,621.81 / $3,311.31 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,621.81 / $4,073.80
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
$1,621.81 / $3,311.31 / $8,317.64
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,897.79 / $7,943.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $6,606.93 / $7,585.78
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,715.35 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,890.45 / $5,011.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,548.13 / $13,489.63
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,467.37 / $14,454.40
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
$3,162.28 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $4,073.80 / $6,918.31
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,467.37 / $5,128.61
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $14,791.08 / $14,791.08
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $7,943.28 / $14,454.40
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $5,370.32
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,011.87 / $9,120.11 / $10,232.93
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
$1,698.24 / $2,884.03 / $6,606.93