go back

Minnesota 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
$1,606.69 / $1,606.69 / $6,575.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,568.52 / $1,606.69 / $2,530.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,696.02 / $8,328.45 / $14,173.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,738.31 / $4,374.71 / $5,519.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,866.53 / $5,486.04 / $13,197.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,892.78 / $4,608.14 / $6,843.79
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,515.02 / $5,015.56 / $10,391.66
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,619.03 / $4,124.63 / $6,276.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,645.05 / $2,715.31 / $4,726.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,775.52 / $3,228.22 / $6,591.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,940.00 / $7,872.00 / $11,531.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,801.11 / $3,228.22 / $6,487.46