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Florida rates for HCPCS 21155

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

Facilitymedian $6,457 · 10th–90th $1,820–$13,1830%10%10th90th$6,457Professionalmedian $2,239 · 10th–90th $1,778–$3,7150%20%10th90th$2,239$50.0$200.0$1.0K$5.0K$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
$1,445.44 / $5,495.41 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,238.72 / $3,548.13
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $6,165.95 / $12,882.50
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,187.76 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $398.11 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,754.23 / $4,365.16
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $13,489.63 / $23,988.33
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,513.56 / $2,511.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $9,549.93 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,290.87 / $4,265.80
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $2,238.72