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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
$404.70 / $4,540.00 / $9,784.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.38 / $579.58 / $1,068.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.50 / $801.13 / $1,792.48
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.98 / $970.32 / $1,001.37
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,606.42 / $13,851.67 / $27,428.23
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.49 / $667.33 / $1,444.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,682.00 / $9,969.00 / $19,696.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.64 / $932.31 / $2,457.92