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Maryland rates for HCPCS 21155

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

Facilitymedian $851 · 10th–90th $513–$2,8840%10%20%10th90th$851Professionalmedian $2,239 · 10th–90th $1,862–$3,8020%20%10th90th$2,239$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,238.72 / $3,801.89
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,454.71 / $3,311.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,754.23 / $4,786.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,238.72 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,174.90 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,454.71 / $4,365.16
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,344.23 / $2,951.21