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North Carolina 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 $4,786 · 10th–90th $1,698–$10,4710%10%10th90th$4,786Professionalmedian $2,089 · 10th–90th $1,549–$5,4950%10%20%10th90th$2,089$100.0$500.0$2.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $5,011.87 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,778.28 / $4,677.35
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $6,165.95 / $8,709.64
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,630.78 / $8,128.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,238.72 / $3,890.45
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $3,890.45
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,187.76 / $3,388.44
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,754.23 / $3,235.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $11,748.98 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,862.09 / $3,467.37
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $21,379.62 / $21,379.62
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $15,488.17 / $15,488.17