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Idaho rates for HCPCS 21110

Appl Interdental Fixation Device Non-Fx/Dislc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,795.36 / $4,500.00 / $7,045.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$757.41 / $1,184.94 / $1,796.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.47 / $735.47 / $737.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$797.26 / $1,151.71 / $1,476.20
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$642.50 / $1,247.50 / $1,976.30
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,131.49 / $1,362.59 / $1,687.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $1,176.42 / $1,328.22
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,734.94 / $3,749.50 / $4,629.45
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,207.83 / $1,459.73 / $1,789.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$675.00 / $3,450.00 / $7,609.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$834.48 / $1,205.35 / $1,674.89