go back

Rhode Island 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
$3,019.95 / $3,715.35 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,041.74 / $5,011.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,949.84 / $3,801.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,162.28 / $4,073.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $7,413.10 / $13,182.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,570.40 / $4,265.80