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Alabama rates for HCPCS 21159

Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); without LeFort I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,513.56 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,754.23 / $5,011.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $7,244.36 / $9,772.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $3,548.13 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $3,019.95 / $5,754.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $4,265.80 / $6,918.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,691.53 / $4,786.30