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Missouri rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$646.45 / $4,610.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.00 / $601.66 / $1,028.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.91 / $675.84 / $1,080.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$566.46 / $835.57 / $1,361.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.05 / $881.66 / $3,532.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.71 / $1,009.20 / $4,812.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,694.00 / $3,018.00 / $10,838.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$622.66 / $886.80 / $1,417.99