go back

Maryland rates for HCPCS 21147

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,455.27 / $1,701.69 / $1,987.98
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,897.25 / $1,897.25 / $2,409.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.00 / $507.00 / $641.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,515.34 / $2,104.17 / $3,886.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,752.55 / $2,260.79 / $2,964.77
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.00 / $847.00 / $1,560.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,314.28 / $1,981.71 / $3,526.91
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,556.15 / $2,015.43 / $2,508.80