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North Dakota rates for HCPCS 21155

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

Facilitymedian $2,138 · 10th–90th $2,138–$8,5110%50%90th$2,138Professionalmedian $3,162 · 10th–90th $2,042–$5,4950%20%10th90th$3,162$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
$2,137.96 / $2,137.96 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,187.76 / $5,370.32
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,677.35 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,073.80 / $6,606.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,019.95 / $5,011.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,715.35 / $22,387.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,041.74 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,630.78 / $5,248.07