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Louisiana rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$675.54 / $2,090.00 / $4,050.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.12 / $796.53 / $1,104.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,582.88 / $4,922.68 / $6,940.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$671.98 / $811.91 / $1,201.55
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $498.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,350.00 / $1,350.00 / $1,350.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$522.16 / $827.16 / $1,227.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$826.00 / $2,918.00 / $7,734.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$573.77 / $763.15 / $1,377.81