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Indiana 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 $15,488 · 10th–90th $2,455–$25,7040%10%10th90th$15,488Professionalmedian $1,738 · 10th–90th $1,514–$4,2660%20%10th90th$1,738$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$1,380.38 / $4,897.79 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,737.80 / $4,570.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $19,054.61 / $27,542.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,737.80 / $2,951.21
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,698.24 / $1,949.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,344.23 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,995.26 / $3,467.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $9,549.93 / $18,197.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,819.70 / $3,162.28