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Kentucky 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
$860.00 / $2,061.44 / $8,229.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,634.30 / $1,880.37 / $2,450.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,720.89 / $10,099.00 / $25,551.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,685.66 / $2,047.28 / $2,918.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,745.21 / $2,499.42 / $2,883.27
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,745.13 / $2,486.34 / $3,570.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,204.04 / $2,204.04 / $2,413.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,018.72 / $2,825.17 / $4,059.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $2,320.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$842.00 / $4,539.00 / $10,113.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,871.72 / $2,618.69 / $3,983.49