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Illinois 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
$1,202.26 / $3,548.13 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,659.59 / $3,467.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,585.78 / $9,120.11 / $33,884.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $1,819.70 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,187.76 / $3,311.31
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,630.27 / $8,128.31
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
$1,905.46 / $1,949.84 / $2,137.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,584.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $6,025.60 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,949.84 / $3,388.44