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Nebraska rates for HCPCS 21151

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,241.22 / $10,431.19 / $20,928.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,670.15 / $1,670.15 / $9,501.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,086.90 / $11,951.75 / $23,118.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,602.80 / $2,732.05 / $3,642.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,135.00 / $4,034.18 / $5,487.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,670.15 / $2,922.76 / $7,441.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,227.54 / $3,684.00 / $5,562.33
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,369.31 / $4,150.78 / $5,581.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,107.29 / $3,943.94 / $5,487.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,178.00 / $7,441.00 / $8,816.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,227.54 / $3,803.95 / $4,797.77