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Idaho rates for HCPCS 21147

Rcnstj Midface Lefort I 3/> Piece W/Bone Grafts

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,256.97 / $4,500.00 / $8,622.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,725.38 / $2,314.29 / $3,547.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,926.39 / $2,605.41 / $3,290.91
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,568.01 / $3,015.37 / $4,290.39
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,727.83 / $2,975.81 / $4,046.91
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $2,388.78 / $3,005.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,072.74 / $7,629.08 / $12,587.97
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,674.91 / $3,380.49 / $4,046.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $10,120.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,846.04 / $2,521.29 / $3,459.41