go back

Illinois 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
$1,202.26 / $3,630.78 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,137.96 / $4,466.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,585.78 / $9,549.93 / $42,657.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $3,162.28 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,754.23 / $4,073.80
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $3,311.31 / $9,549.93
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,454.71 / $2,691.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,905.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $6,025.60 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,511.89 / $4,073.80