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Maryland rates for HCPCS 21151

Reconstruction midface, LeFort II; any direction, requiring bone grafts (includes obtaining autografts)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,905.46 / $5,011.87
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,041.74 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,344.23 / $4,073.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,819.70 / $3,162.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $1,174.90 / $2,884.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,089.30 / $3,715.35
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,949.84 / $2,454.71