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West 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 $1,660 · 10th–90th $1,413–$2,8840%20%40%10th90th$1,660Professionalmedian $1,660 · 10th–90th $1,549–$3,0200%20%40%10th90th$1,660$50.0$200.0$1.0K$5.0K

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
$1,412.54 / $1,659.59 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,659.59 / $3,019.95
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $2,137.96
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $2,884.03 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,454.71 / $8,128.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $16,595.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,778.28 / $2,570.40