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Nebraska 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 $7,943 · 10th–90th $3,090–$13,4900%10%20%10th90th$7,943Professionalmedian $2,455 · 10th–90th $1,585–$5,7540%20%10th90th$2,455$1.0K$2.0K$5.0K$10.0K$20.0K

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
$5,011.87 / $7,943.28 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,290.87 / $9,332.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $11,748.98 / $22,908.68
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,570.40 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $5,754.40 / $5,754.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,981.07 / $5,011.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,818.38 / $8,912.51
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,235.94 / $15,135.61
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,073.80 / $5,248.07
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $5,754.40 / $5,754.40
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,801.89 / $5,248.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $7,413.10 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,090.30 / $4,365.16