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Hawaii 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 $5,495 · 10th–90th $1,950–$5,4950%50%10th$5,495Professionalmedian $1,995 · 10th–90th $1,660–$2,9510%20%10th90th$1,995$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,949.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,778.28 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,137.96 / $2,570.40
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,691.53 / $2,951.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,862.09 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,949.84 / $2,511.89
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $1,548.82 / $2,511.89