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Iowa 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 $4,786 · 10th–90th $2,754–$10,9650%10%10th90th$4,786Professionalmedian $1,995 · 10th–90th $1,585–$4,3650%20%10th90th$1,995$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$2,754.23 / $4,786.30 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,778.28 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,981.07 / $5,011.87
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,290.87 / $8,511.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,890.45 / $11,481.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,235.94 / $15,135.61
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $4,073.80 / $4,570.88
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $10,964.78 / $15,488.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,511.89 / $4,677.35
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,311.31 / $3,890.45