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Wyoming rates for HCPCS 21147

Rcnstj Midface Lefort I 3/> Piece W/Bone Grafts

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,699.56 / $1,725.97 / $2,188.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,239.00 / $3,887.00 / $5,879.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,405.28 / $3,451.94 / $4,722.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,188.00 / $5,188.00 / $18,767.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,421.58 / $3,477.92 / $5,739.50