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Connecticut rates for HCPCS 21155

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

Facilitymedian $6,761 · 10th–90th $4,074–$11,4820%10%10th90th$6,761Professionalmedian $2,512 · 10th–90th $1,950–$5,6230%10%10th90th$2,512$1.0K$2.0K$5.0K$10.0K$20.0K

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
$4,073.80 / $6,025.60 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,344.23 / $5,623.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $15,135.61 / $16,595.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $4,265.80 / $5,888.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,981.07 / $5,754.40
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,630.78 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $10,232.93 / $16,218.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,235.94 / $5,754.40