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Alabama rates for HCPCS 21147

Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple osteotomies)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,513.56 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,778.28 / $3,467.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $7,244.36 / $9,772.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,951.21 / $4,168.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $2,884.03 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,089.30 / $3,890.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $4,265.80 / $6,918.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,698.24 / $2,951.21