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Kansas rates for HCPCS 21155

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

Facilitymedian $5,012 · 10th–90th $2,754–$10,4710%10%10th90th$5,012Professionalmedian $2,754 · 10th–90th $1,950–$3,5480%20%10th90th$2,754$100.0$500.0$2.0K$10.0K

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
$2,818.38 / $5,623.41 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,238.72 / $3,630.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $3,388.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,884.03 / $4,466.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $3,162.28 / $6,456.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,951.21 / $22,387.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,466.84 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,691.53 / $3,548.13