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Wyoming rates for HCPCS 21155

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

Facilitymedian $12,023 · 10th–90th $5,129–$18,6210%20%40%10th90th$12,023Professionalmedian $4,169 · 10th–90th $2,138–$7,5860%20%10th90th$4,169$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
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,187.76 / $4,466.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $6,309.57 / $7,585.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,715.35 / $5,011.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $12,022.64 / $18,620.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,168.69 / $7,585.78