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New Jersey 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
$2,079.88 / $6,396.00 / $11,298.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,765.13 / $2,052.44 / $3,181.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,937.08 / $2,948.63 / $6,129.26
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,760.87 / $3,019.86 / $3,022.95
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,556.16 / $2,407.29 / $5,532.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,682.00 / $9,969.00 / $19,696.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,628.11 / $2,446.40 / $5,760.18