go back

Wisconsin 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 $10,233 · 10th–90th $5,248–$16,9820%5%10%10th90th$10,233Professionalmedian $3,802 · 10th–90th $2,399–$11,2200%10%20%10th90th$3,802$50.0$200.0$1.0K$5.0K$20.0K

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
$2,511.89 / $5,248.07 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,570.40 / $6,456.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $5,248.07 / $12,882.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $7,762.47 / $12,302.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $10,471.29 / $11,748.98
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $5,754.40 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $6,165.95 / $7,943.28
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $5,248.07 / $13,489.63
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $4,897.79 / $27,542.29
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $6,025.60 / $10,964.78
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $5,248.07 / $7,943.28
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $23,442.29 / $23,442.29
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $12,589.25 / $27,542.29
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $8,317.64
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,511.38 / $14,125.38 / $16,218.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,981.07 / $10,715.19