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North Carolina rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$533.54 / $1,245.00 / $10,453.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533.54 / $631.16 / $1,174.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,920.34 / $1,920.34 / $1,948.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.00 / $993.02 / $1,930.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$748.70 / $748.70 / $2,393.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$628.07 / $854.34 / $1,682.50
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$533.54 / $750.85 / $1,276.79
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$716.00 / $1,055.00 / $1,055.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $861.40 / $2,183.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,661.00 / $7,659.00 / $10,502.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.38 / $864.80 / $1,730.32
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,791.10 / $3,791.10 / $26,542.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,008.16 / $4,721.60 / $5,455.58