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Maryland 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 $1,175 · 10th–90th $513–$2,8840%10%20%10th90th$1,175Professionalmedian $1,738 · 10th–90th $1,445–$3,0900%20%10th90th$1,738$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,737.80 / $2,951.21
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,949.84 / $2,691.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,089.30 / $3,890.45
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,819.70 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,174.90 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,905.46 / $3,467.37
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,905.46 / $2,454.71