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Alaska rates for HCPCS 21188

Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,616.27 / $9,774.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,470.56 / $7,829.38 / $7,829.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,010.68 / $5,406.76 / $6,804.99
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,474.01 / $7,829.38 / $10,961.13
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,828.20 / $4,593.84 / $9,325.98
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,917.50 / $8,010.04 / $9,718.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,474.01 / $7,829.38 / $10,961.13
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,372.81 / $7,786.35 / $10,689.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,054.54 / $7,413.47 / $9,515.92