go back

Connecticut 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
$1,288.25 / $5,888.44 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $724.44 / $1,778.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $4,168.69 / $12,022.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,230.27 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $3,801.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,122.02 / $1,778.28
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $1,071.52 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $7,079.46 / $11,220.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $891.25 / $1,778.28