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New Jersey rates for HCPCS 21155

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

Facilitymedian $7,586 · 10th–90th $4,467–$11,7490%10%10th90th$7,586Professionalmedian $2,399 · 10th–90th $1,862–$7,0790%10%20%10th90th$2,399$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
$4,466.84 / $7,413.10 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,238.72 / $7,244.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,162.28 / $6,760.83
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,290.87 / $3,162.28
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,748.98 / $16,595.87 / $30,902.95
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,570.40 / $10,715.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $8,709.64 / $15,488.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,344.23 / $5,495.41