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Oregon 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 $3,311 · 10th–90th $2,042–$13,8040%20%10th90th$3,311Professionalmedian $2,754 · 10th–90th $1,549–$4,5710%10%20%10th90th$2,754$1.0$5.0$20.0$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
$2,454.71 / $7,943.28 / $18,620.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,778.28 / $4,677.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,090.30 / $4,570.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,311.31 / $4,073.80
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,754.23 / $4,365.16
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,019.95 / $4,365.16
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,311.31 / $3,388.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,630.27 / $3,981.07
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $3,235.94 / $4,570.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,623.41 / $8,912.51 / $21,877.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,890.45 / $5,011.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $17,782.79 / $25,703.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,235.94 / $4,570.88