go back

Arkansas 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
$741.31 / $1,174.90 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $660.69 / $977.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $2,884.03 / $3,981.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $691.83 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $891.25 / $1,122.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $2,137.96 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $724.44 / $1,174.90