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Minnesota 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 / $2,570.40 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,570.40 / $4,168.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $6,025.60 / $20,892.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $6,025.60 / $9,332.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $9,332.54 / $22,387.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $7,413.10 / $11,220.18
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,079.46 / $8,912.51 / $17,378.01
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $6,309.57 / $10,000.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $4,365.16 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $4,897.79 / $14,125.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $5,754.40 / $12,589.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $4,677.35 / $9,120.11