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Colorado 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
$2,089.30 / $5,495.41 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $676.08 / $1,348.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $6,456.54 / $10,964.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $794.33 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,995.26 / $6,309.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $870.96 / $1,380.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $758.58 / $2,754.23
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $676.08 / $1,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $6,025.60 / $11,481.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $891.25 / $1,479.11