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Florida 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
$1,638.18 / $4,790.00 / $11,576.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.09 / $1,943.27 / $2,588.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.00 / $400.00 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,609.86 / $2,508.87 / $4,195.07
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,624.00 / $21,162.00 / $32,051.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$923.04 / $1,846.08 / $2,284.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.50 / $1,440.12 / $2,475.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,581.00 / $10,309.00 / $15,888.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,512.72 / $2,121.40 / $3,849.63
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,490.07 / $1,490.07 / $1,912.26