go back

New Mexico 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
$1,000.00 / $2,095.00 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,427.36 / $1,630.56 / $6,604.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,571.96 / $2,289.92 / $2,972.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $2,411.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.45 / $2,006.19 / $3,528.77
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,579.26 / $2,447.85 / $3,881.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$899.00 / $11,259.00 / $16,897.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,759.69 / $2,369.00 / $3,716.16