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Alabama rates for HCPCS 21154

Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); without LeFort I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,513.56 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,137.96 / $3,981.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $7,244.36 / $9,772.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,691.53 / $3,388.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $3,311.31 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,570.40 / $4,365.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $4,265.80 / $6,918.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,041.74 / $3,715.35