go back

Minnesota 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
$562.34 / $676.08 / $676.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $676.08 / $1,071.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $7,585.78 / $14,791.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,380.38 / $2,238.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $2,454.71 / $5,754.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,862.09 / $2,818.38
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $2,344.23 / $4,570.88
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,659.59 / $2,630.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $1,071.52 / $2,041.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $1,479.11 / $4,073.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $4,786.30 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $1,258.93 / $2,187.76