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Mississippi 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
$870.96 / $1,819.70 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,570.40 / $5,011.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $5,128.61 / $5,128.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $4,073.80 / $5,370.32
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $4,073.80 / $11,748.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,951.21 / $6,456.54