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Michigan rates for HCPCS 21347

Open treatment of nasomaxillary complex fracture (LeFort II type); requiring multiple open approaches

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,322.02 / $4,933.00 / $5,757.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$940.75 / $1,166.09 / $1,372.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,328.21 / $6,253.76 / $8,472.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.48 / $927.24 / $1,717.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$763.36 / $1,203.46 / $2,227.79
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,128.22 / $4,933.00 / $5,757.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,017.16 / $1,162.47 / $1,638.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.96 / $702.51 / $1,211.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,500.00 / $8,702.00 / $10,652.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,091.04 / $1,309.04 / $1,798.37