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Alabama rates for HCPCS 21421

Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire fixation or fixation of denture or splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,513.56 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $707.95 / $1,348.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $4,570.88 / $6,309.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $891.25 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $912.01 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $831.76 / $1,445.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $2,951.21 / $4,365.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $616.60 / $1,096.48