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Missouri rates for HCPCS 21401

Closed Tx Fx Orbit Except Blowout W/Manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.29 / $3,907.00 / $7,996.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.36 / $429.88 / $658.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.39 / $359.19 / $536.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.08 / $538.13 / $992.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.94 / $575.46 / $2,363.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$483.32 / $751.35 / $3,776.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$825.00 / $2,261.00 / $3,071.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.06 / $651.28 / $1,090.68