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Illinois 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $4,265.80 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $3,019.95 / $6,165.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,585.78 / $10,232.93 / $61,659.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $3,981.07 / $5,888.44
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $4,786.30 / $11,220.18
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,311.31 / $3,548.13 / $3,890.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $2,754.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $6,025.60 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $3,388.44 / $5,888.44