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Hawaii rates for HCPCS 21160

Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); with LeFort I

Facilitymedian $5,495 · 10th–90th $1,950–$5,4950%50%10th$5,495Professionalmedian $3,236 · 10th–90th $2,512–$4,8980%10%20%10th90th$3,236$50.0$200.0$1.0K$5.0K

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
$1,949.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,951.21 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,467.37 / $4,168.69
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $4,466.84 / $4,897.79
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,884.03 / $3,548.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,467.37 / $4,168.69
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $2,511.89 / $5,011.87