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Pennsylvania rates for HCPCS 21110

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

Facilitymedian $2,692 · 10th–90th $813–$8,3180%5%10%10th90th$2,692Professionalmedian $813 · 10th–90th $646–$1,4450%20%10th90th$813$10.0$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
$831.76 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $812.83 / $1,380.38
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,691.53 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,000.00 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $870.96 / $1,548.82
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,445.44 / $1,819.70
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,023.29 / $1,445.44
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $3,548.13
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,995.26 / $7,244.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $812.83 / $1,778.28
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $1,258.93 / $1,819.70
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $575.44 / $616.60
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $575.44 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,818.38 / $5,495.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $831.76 / $1,479.11