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Rhode Island rates for HCPCS 21155

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

Facilitymedian $3,981 · 10th–90th $3,020–$12,5890%10%10th90th$3,981Professionalmedian $2,239 · 10th–90th $1,820–$4,6770%10%20%10th90th$2,239$1.0K$2.0K$5.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,715.35 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,187.76 / $4,677.35
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,511.89 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,548.13 / $4,466.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $7,413.10 / $13,182.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,818.38 / $4,786.30