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Utah 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 $6,607 · 10th–90th $3,162–$10,2330%10%10th90th$6,607Professionalmedian $2,188 · 10th–90th $1,413–$9,3330%10%20%10th90th$2,188$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
$3,162.28 / $6,025.60 / $9,120.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,949.84 / $9,332.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,344.23 / $3,548.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $4,677.35
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $10,471.29 / $15,135.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,818.38 / $4,677.35
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,981.07 / $5,370.32
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,454.71 / $3,715.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,778.28 / $2,884.03