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North Dakota 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
$1,621.81 / $1,621.81 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,621.81 / $3,715.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,754.23 / $3,388.44 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $3,019.95 / $5,011.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $1,995.26 / $3,388.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,951.21 / $15,488.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,041.74 / $11,481.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,884.03 / $3,890.45