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Indiana rates for HCPCS 21100

Appl Halo Appliance Maxillofacial Fixation Spx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$334.38 / $927.00 / $7,212.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.12 / $501.84 / $785.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,310.00 / $6,340.00 / $15,727.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.64 / $343.30 / $473.75
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.91 / $432.78 / $765.29
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563.15 / $675.78 / $844.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,909.74 / $3,909.74 / $4,634.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.85 / $574.57 / $1,072.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,472.00 / $10,113.00 / $15,750.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$567.14 / $751.89 / $1,364.30