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Connecticut 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
$3,890.45 / $6,025.60 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,698.24 / $4,570.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $15,135.61 / $16,595.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $3,162.28 / $4,570.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,884.03 / $4,365.16
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,344.23 / $2,951.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $10,232.93 / $16,218.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,344.23 / $4,466.84