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Utah rates for HCPCS 21345

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

Facilitymedian $4,571 · 10th–90th $1,096–$10,2330%10%10th90th$4,571Professionalmedian $912 · 10th–90th $617–$4,0740%5%10%10th90th$912$50.0$200.0$1.0K$5.0K

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
$1,096.48 / $4,570.88 / $10,232.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $891.25 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $933.25 / $1,348.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,258.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,884.03 / $4,466.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,202.26 / $1,995.26
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,258.93 / $1,698.24
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,096.48 / $1,584.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $776.25 / $1,174.90