go back

Missouri rates for HCPCS 21147

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,718.54 / $4,931.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,436.81 / $1,718.54 / $2,812.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.00 / $4,490.00 / $12,405.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,576.76 / $2,041.00 / $3,156.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,576.46 / $2,248.25 / $3,675.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,379.56 / $2,294.25 / $4,838.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.87 / $2,391.17 / $14,973.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,858.00 / $4,000.00 / $11,258.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,557.68 / $2,211.73 / $3,691.71