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Arizona 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)

Facilitymedian $4,677 · 10th–90th $2,042–$8,7100%10%10th90th$4,677Professionalmedian $1,778 · 10th–90th $1,514–$4,2660%20%10th90th$1,778$100.0$500.0$2.0K$10.0K

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
$2,137.96 / $4,677.35 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,778.28 / $4,265.80
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $7,413.10 / $13,489.63
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,290.87 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,949.84 / $3,388.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,290.87 / $8,128.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,995.26 / $15,135.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $5,495.41 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,737.80 / $3,090.30