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Kentucky rates for HCPCS 21155

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

Facilitymedian $8,511 · 10th–90th $851–$10,7150%10%20%10th90th$8,511Professionalmedian $2,239 · 10th–90th $1,862–$3,8020%10%20%10th90th$2,239$50.0$200.0$1.0K$5.0K

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
$794.33 / $3,235.94 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,187.76 / $3,801.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $10,715.19 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,290.87 / $3,235.94
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,691.53 / $3,467.37
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,691.53 / $3,235.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $3,630.78 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,388.44 / $14,454.40
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,778.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $6,025.60 / $10,471.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,691.53 / $4,265.80