Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Lefort i-3/> piece w/o graft
Devils Lake, ND
See all hospitals reporting CPT 21143 →Price type
Altru Hospital Devils Lake’s median price of $6.4k is 3% above the median hospital's median price ($6.2k), higher than 54% of the 1,471 hospitals reporting CPT 21143. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 10 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Medica medicaid managed care plan facility · fee schedule · outpatient | $1.6k | $1.6k | $732 | 47% | — | $841 – $2.3k |
| 2 | Medica medicaid managed care plan – hmo facility · fee schedule · outpatient | $1.6k | $1.6k | $732 | 47% | — | $841 – $2.3k |
| 3 | Medica medicare managed care plan facility · fee schedule · outpatient | $2.2k | $2.2k | $673 | 31% | — | $1.5k – $2.9k |
| 4 | Blue Cross Blue Shield medicaid managed care plan facility · fee schedule · outpatient | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 5 | Medica all commercial plans facility · fee schedule · outpatient | $5.7k | $5.7k | $3.2k | 57% | — | $2.5k – $8.9k |
| 6 | Aetna medicare managed care plan facility · fee schedule · outpatient | $6.0k | $6.0k | — | — | — | $6.0k – $6.0k |
| 7 | Aetna all commercial plans facility · fee schedule · outpatient | $6.5k | $7.9k | $2.1k | 27% | — | $6.4k – $10.9k |
| 8 | Sanford Health Plan all commercial plans facility · fee schedule · outpatient | $8.3k | $8.3k | $1.2k | 15% | — | $7.1k – $9.5k |
| 9 | Blue Cross Blue Shield all commercial plans facility · fee schedule · outpatient | $10.7k | $10.7k | — | — | — | $10.7k – $10.7k |
| 10 | UnitedHealthcare all commercial plans facility · fee schedule · outpatient | $11.8k | $11.8k | — | — | — | $11.8k – $11.8k |
Last updated: Mar 1, 2026
See Midface reconstruction: upper jaw cut into three or more pieces pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.