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Massachusetts 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 $3,631 · 10th–90th $1,820–$6,9180%10%10th90th$3,631Professionalmedian $2,042 · 10th–90th $1,549–$4,5710%10%10th90th$2,042$100.0$500.0$2.0K$10.0K$50.0K

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 / $3,630.78 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,905.46 / $4,570.88
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $5,011.87 / $16,595.87
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,570.40 / $15,488.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,454.71 / $4,897.79
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,137.96 / $4,897.79
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,089.30 / $2,951.21
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $6,165.95 / $13,182.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,818.38 / $4,073.80
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $5,011.87 / $16,595.87
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,570.40 / $15,488.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $5,888.44 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,570.40 / $4,786.30