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New Mexico 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 $2,455 · 10th–90th $1,660–$7,7620%20%10th90th$2,455Professionalmedian $1,778 · 10th–90th $1,514–$2,9510%20%10th90th$1,778$50.0$200.0$1.0K$5.0K$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
$2,041.74 / $2,454.71 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,737.80 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,344.23 / $5,754.40
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,187.76 / $3,630.78
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,398.83 / $3,548.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $11,748.98 / $25,703.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,398.83 / $3,467.37