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New Jersey rates for HCPCS 21100

Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,090.30 / $5,888.44 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $575.44 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $776.25 / $1,778.28
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $812.83 / $1,071.52
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $19,054.61 / $30,199.52
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $707.95 / $1,862.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $9,120.11 / $21,379.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $602.56 / $1,513.56