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Kansas 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
$2,982.00 / $6,071.00 / $13,151.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,333.07 / $2,619.64 / $4,128.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,472.36 / $4,085.13 / $4,085.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$624.00 / $624.00 / $624.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,709.24 / $3,594.70 / $5,124.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,188.46 / $3,841.49 / $7,310.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.92 / $3,461.56 / $27,619.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,967.00 / $4,960.00 / $11,732.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.92 / $3,281.05 / $4,531.97