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Delaware 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
$6,025.60 / $6,025.60 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $660.69 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,513.56 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $660.69 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,479.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $660.69 / $1,071.52