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Illinois rates for HCPCS 21155

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

Facilitymedian $4,169 · 10th–90th $1,288–$9,7720%10%10th90th$4,169Professionalmedian $2,570 · 10th–90th $1,950–$4,8980%20%10th90th$2,570$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
$1,202.26 / $4,073.80 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,398.83 / $4,570.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $10,232.93 / $47,863.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,019.95 / $4,570.88
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,630.78 / $9,549.93
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,691.53 / $2,951.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $5,370.32 / $12,302.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,691.53 / $4,466.84