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Kansas 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
$1,148.15 / $5,495.41 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $676.08 / $1,122.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $1,659.59 / $1,659.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $851.14 / $1,318.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $933.25 / $4,168.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $977.24 / $4,786.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $2,570.40 / $4,677.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $758.58 / $1,071.52