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Maine rates for HCPCS 21436

Open treatment of craniofacial separation (LeFort III type); complicated, multiple surgical approaches, internal fixation, with bone grafting (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,697.62 / $2,126.05 / $2,592.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,491.08 / $26,019.37 / $30,263.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,124.60 / $2,749.49 / $3,883.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,063.85 / $3,101.40 / $4,379.39
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,536.27 / $2,934.46 / $4,501.63
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,697.62 / $2,387.98 / $2,592.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,970.03 / $2,885.21 / $4,031.00