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New Hampshire 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 $8,913 · 10th–90th $2,399–$14,7910%10%20%10th90th$8,913Professionalmedian $3,631 · 10th–90th $2,570–$6,4570%10%10th90th$3,631$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$2,398.83 / $9,772.37 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,090.30 / $6,606.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,623.41 / $9,120.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $4,897.79 / $6,918.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,570.88 / $7,762.47
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,801.89 / $5,495.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,981.07 / $7,079.46
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $3,090.30