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New Jersey 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
$1,651.80 / $6,396.00 / $11,298.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,422.71 / $1,627.51 / $2,713.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,508.03 / $2,327.21 / $4,712.97
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,413.74 / $2,424.65 / $2,469.50
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,312.36 / $1,897.38 / $3,948.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,682.00 / $9,969.00 / $19,696.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,299.15 / $1,995.61 / $5,500.00