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Arkansas rates for HCPCS 21155

Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); with LeFort I

Facilitymedian $2,042 · 10th–90th $1,514–$3,8020%10%10th90th$2,042Professionalmedian $2,239 · 10th–90th $1,950–$3,3880%20%10th90th$2,239$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,995.26 / $3,235.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,187.76 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,311.31 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $4,365.16 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,691.53 / $4,073.80