go back

Pennsylvania 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
$1,085.43 / $4,048.00 / $8,451.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$940.75 / $1,050.97 / $1,506.85
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,030.49 / $1,069.38 / $1,593.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,166.55 / $1,166.55 / $1,166.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$995.50 / $1,312.41 / $2,109.16
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,216.58 / $1,629.21 / $2,101.38
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,085.43 / $4,993.00 / $10,247.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$958.78 / $1,136.30 / $5,217.95
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,042.70 / $1,042.70 / $2,341.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,166.55 / $1,166.55 / $1,166.55
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$995.50 / $1,316.01 / $2,208.21
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,017.61 / $1,017.61 / $1,120.69
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$992.26 / $1,017.61 / $1,120.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,332.00 / $3,879.00 / $7,508.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.75 / $1,230.01 / $2,032.18