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Utah rates for HCPCS 21100

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

Facilitymedian $3,715 · 10th–90th $891–$6,4570%10%10th90th$3,715Professionalmedian $708 · 10th–90th $331–$2,2910%5%10th90th$708$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $3,388.44 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $707.95 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $707.95 / $1,318.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $954.99
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $11,481.54 / $17,782.79
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $851.14 / $1,698.24
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $741.31 / $1,318.26
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $851.14 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $588.84 / $1,047.13