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Wyoming 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
$1,577.11 / $1,605.97 / $2,077.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,004.00 / $3,605.00 / $5,454.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,130.44 / $3,195.66 / $4,389.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,188.00 / $5,188.00 / $18,767.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,916.64 / $3,243.73 / $5,662.78