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Wisconsin rates for HCPCS 21100

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

Facilitymedian $9,772 · 10th–90th $759$16,9820%5%10%10th90th$9,772Professionalmedian $676 · 10th–90th $347$2,0890%10%10th90th$676$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
$354.81 / $758.58 / $3,090.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $575.44 / $1,288.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $812.83 / $2,187.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,949.84 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $1,445.44 / $2,951.21
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $758.58 / $3,548.13
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,122.02 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $776.25 / $13,182.57
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,479.11 / $4,570.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $512.86
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,445.44 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,174.90 / $2,089.30
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $11,220.18 / $16,595.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $3,235.94 / $4,466.84
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $2,089.30
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $2,290.87 / $3,981.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $831.76 / $2,344.23