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Delaware 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
$5,816.00 / $5,816.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,525.52 / $1,683.03 / $1,701.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,485.75 / $1,715.04 / $3,070.07
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,357.53 / $18,357.53 / $18,357.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,530.00 / $2,530.00 / $2,530.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,425.42 / $1,695.40 / $3,975.07