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Idaho rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,422.00 / $4,500.00 / $8,622.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.20 / $896.66 / $1,334.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,674.04 / $1,674.04 / $1,678.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$706.69 / $942.25 / $1,178.33
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$558.00 / $1,129.93 / $1,590.35
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$884.37 / $1,071.96 / $1,287.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $905.00 / $1,138.55
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,803.94 / $7,766.93 / $9,755.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$926.27 / $1,124.57 / $1,345.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,350.00 / $5,550.00 / $12,233.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.46 / $1,053.00 / $1,674.52