go back

Mississippi 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
$870.96 / $1,819.70 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,949.84 / $3,801.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $3,019.95 / $4,365.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $4,073.80 / $11,748.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,290.87 / $4,677.35