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Indiana rates for HCPCS 21421

Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire fixation or fixation of denture or splint

Facilitymedian $8,128 · 10th–90th $1,175–$11,2200%10%10th90th$8,128Professionalmedian $646 · 10th–90th $513–$1,2300%10%20%10th90th$646$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $4,897.79 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $630.96 / $1,288.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $8,317.64 / $10,964.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $562.34 / $912.01
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $549.54 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $831.76 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $691.83 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $5,623.41 / $14,125.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $691.83 / $1,202.26