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Colorado 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
$2,018.00 / $5,503.00 / $10,651.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,790.05 / $1,928.30 / $2,728.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,946.00 / $9,834.00 / $18,248.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,151.35 / $2,754.37 / $4,396.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,185.14 / $2,766.87 / $3,867.21
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,928.30 / $2,740.94 / $3,432.37
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,100.12 / $2,768.34 / $3,818.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,251.00 / $11,924.00 / $19,712.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,151.27 / $2,826.19 / $4,367.91