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Nevada 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
$2,240.00 / $3,042.00 / $6,953.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,333.07 / $2,604.17 / $13,574.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,877.00 / $5,379.00 / $14,000.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,900.41 / $3,292.42 / $4,389.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,259.60 / $3,310.99 / $4,676.00
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.60 / $2,824.30 / $4,803.52
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.20 / $3,263.73 / $6,004.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,042.00 / $4,794.00 / $10,407.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,371.37 / $3,100.75 / $4,699.18