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Tennessee 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
$1,619.33 / $3,522.29 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,619.33 / $1,908.23 / $2,991.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,695.00 / $5,467.00 / $9,283.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,854.55 / $2,535.46 / $3,884.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,912.21 / $2,607.56 / $3,805.48
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $16,423.12 / $16,900.40
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18,236.43 / $18,236.43 / $18,236.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,905.00 / $6,073.00 / $10,287.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,691.60 / $2,430.26 / $4,041.73