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Arizona rates for HCPCS 21110

Application of interdental fixation device for conditions other than fracture or dislocation, includes removal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $3,090.30 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $831.76 / $2,187.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $1,778.28 / $2,691.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,096.48 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $870.96 / $1,513.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $933.25 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $1,047.13 / $6,309.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $2,041.74 / $4,786.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $741.31 / $1,318.26