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Utah 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
$1,548.82 / $6,025.60 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,348.96 / $5,754.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,479.11 / $2,238.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $2,398.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $9,772.37 / $22,387.21
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,905.46 / $2,884.03
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,905.46 / $2,398.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,621.81 / $2,398.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,122.02 / $1,737.80