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Arizona rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $4,474.00 / $7,960.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.88 / $607.96 / $3,038.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$830.45 / $3,126.40 / $5,113.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$627.36 / $772.14 / $890.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.29 / $765.67 / $1,297.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$548.77 / $713.40 / $3,612.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.64 / $825.86 / $4,812.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,343.00 / $3,339.00 / $5,838.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.27 / $719.82 / $1,268.68