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Hawaii 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

Facilitymedian $5,495 · 10th–90th $1,950–$5,4950%50%10th$5,495Professionalmedian $2,951 · 10th–90th $2,344–$4,5710%20%10th90th$2,951$50.0$200.0$1.0K$5.0K

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
$1,949.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,691.53 / $4,570.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,162.28 / $3,801.89
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,981.07 / $4,466.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,630.27 / $3,311.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,311.31 / $4,073.80
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $2,344.23 / $5,128.61