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Utah 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
Facility
Modifier
Low / Median / High Price
$2,951.21 / $6,025.60 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,570.40 / $10,964.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,754.23 / $4,786.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $4,466.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $9,772.37 / $21,379.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $3,981.07 / $6,760.83
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $3,715.35 / $5,011.87
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $3,235.94 / $4,897.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,137.96 / $3,311.31