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Georgia rates for HCPCS 21155

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

Facilitymedian $5,370 · 10th–90th $2,042–$8,3180%10%10th90th$5,370Professionalmedian $2,570 · 10th–90th $1,950–$4,6770%10%20%10th90th$2,570$200.0$500.0$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
$3,467.37 / $5,495.41 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,398.83 / $4,466.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $4,073.80 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,548.13 / $4,786.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,467.37 / $5,495.41
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,630.27 / $7,079.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $6,309.57 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,019.95 / $4,786.30