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Virginia 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 $3,631 · 10th–90th $1,660$10,9650%5%10th90th$3,631Professionalmedian $1,950 · 10th–90th $1,479$3,8900%10%20%10th90th$1,950$500.0$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
$1,737.80 / $5,888.44 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,737.80 / $3,467.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $7,413.10 / $9,332.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,398.83 / $4,168.69
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,570.40 / $10,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,041.74 / $3,548.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,862.09 / $2,187.76
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,398.83 / $3,890.45
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,187.76 / $3,311.31
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,089.30 / $9,549.93
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,089.30 / $9,549.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $10,471.29 / $21,379.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,949.84 / $3,235.94