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Colorado 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
$2,570.40 / $5,495.41 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,630.27 / $6,456.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,025.60 / $11,481.54 / $23,988.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,884.03 / $3,715.35 / $5,754.40
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
$2,691.53 / $3,548.13 / $5,370.32
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $3,162.28 / $9,549.93
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $3,890.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $12,022.64 / $18,620.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $3,630.78 / $6,165.95