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Vermont rates for HCPCS 21188

Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,878.99 / $1,987.97 / $1,987.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,662.75 / $2,828.65 / $3,687.66
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,699.39 / $2,430.96 / $3,687.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,062.40 / $2,278.44 / $6,733.24