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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
$1,445.44 / $1,995.26 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,238.72 / $3,715.35
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,238.72 / $2,630.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,290.87 / $3,981.07