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Washington, DC rates for HCPCS 21155

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

Facilitymedian $5,129 · 10th–90th $2,138–$7,7620%10%10th90th$5,129Professionalmedian $2,239 · 10th–90th $1,950–$5,0120%20%10th90th$2,239$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
$2,137.96 / $5,128.61 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,238.72 / $4,786.30
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,365.16 / $10,715.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,090.30 / $5,888.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $4,365.16 / $4,897.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $13,182.57 / $33,113.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,754.23 / $5,888.44