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Maine 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 $12,023 · 10th–90th $12,023–$12,0230%50%100%$12,023Professionalmedian $2,089 · 10th–90th $1,585–$4,2660%10%20%10th90th$2,089$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
$1,584.89 / $1,949.84 / $4,570.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,454.71 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,511.89 / $3,801.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,290.87 / $4,265.80
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,819.70 / $2,454.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $12,022.64 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,187.76 / $3,548.13