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Oklahoma 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
$1,445.44 / $3,890.45 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,630.27 / $4,786.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $3,090.30 / $3,388.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,754.23 / $3,548.13 / $4,570.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $3,890.45 / $9,120.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,951.21 / $27,542.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $5,754.40 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,691.53 / $3,801.89