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Indiana rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$513.39 / $1,030.00 / $14,063.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.39 / $588.47 / $772.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.00 / $6,653.00 / $11,752.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.70 / $562.79 / $776.66
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.02 / $651.33 / $798.80
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$590.20 / $666.44 / $885.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,868.80 / $1,868.80 / $2,215.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.27 / $721.82 / $1,250.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,364.00 / $6,032.00 / $10,413.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.74 / $755.37 / $1,344.29