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Michigan rates for HCPCS 21348

Open treatment of nasomaxillary complex fracture (LeFort II type); with bone grafting (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $5,754.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,122.02 / $1,949.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,659.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $1,659.59 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,258.93 / $3,162.28
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $4,897.79 / $6,918.31
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,230.27 / $1,737.80
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,258.93 / $1,949.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $7,943.28 / $14,791.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,348.96 / $1,778.28