go back

Massachusetts 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
$1,451.46 / $2,747.00 / $5,039.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,443.29 / $1,627.51 / $2,530.94
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,591.00 / $5,050.41 / $13,133.71
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,625.35 / $2,738.19 / $15,441.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,609.13 / $2,757.29 / $4,655.80
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $2,482.98 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,803.31 / $2,184.40 / $2,981.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,939.05 / $3,668.88 / $4,829.39
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,063.00 / $13,773.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,764.72 / $2,924.30 / $15,441.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,324.00 / $5,097.00 / $10,764.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,655.43 / $2,351.46 / $4,601.35