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Tennessee 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
$1,256.00 / $2,940.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$919.83 / $1,071.08 / $1,699.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,013.00 / $6,223.00 / $9,419.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.45 / $1,438.10 / $2,240.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,075.75 / $1,448.18 / $2,113.46
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $9,518.56 / $9,743.68
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,228.59 / $10,228.59 / $10,228.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,905.00 / $6,073.00 / $10,287.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$944.21 / $1,274.39 / $2,204.01