go back

Hawaii rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,635.55 / $2,747.00 / $5,484.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$632.65 / $632.65 / $745.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.46 / $858.41 / $1,030.09
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$867.92 / $1,021.08 / $1,256.26
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$633.16 / $755.40 / $863.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,981.00 / $1,981.00 / $1,981.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.51 / $858.41 / $1,128.42
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.58 / $3,098.10 / $8,000.00