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Michigan rates for HCPCS 21345

Closed treatment of nasomaxillary complex fracture (LeFort II type), with interdental wire fixation or fixation of denture or splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$816.58 / $4,933.00 / $6,853.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$596.78 / $816.58 / $1,054.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,075.15 / $3,609.33 / $4,890.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.98 / $629.90 / $1,114.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$567.57 / $826.70 / $1,435.98
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$801.78 / $4,933.00 / $6,853.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.95 / $843.98 / $1,182.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.56 / $550.25 / $907.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,050.00 / $3,640.00 / $6,327.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.92 / $931.20 / $1,305.65