go back

North Carolina 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
$870.96 / $1,698.24 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $676.08 / $1,659.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $1,905.46 / $1,949.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $870.96 / $1,949.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $741.31 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $851.14 / $1,584.89
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $912.01 / $1,548.82
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $758.58 / $1,318.26
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,258.93 / $1,659.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $6,918.31 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $707.95 / $1,318.26
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,943.28 / $7,943.28 / $33,884.42
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,677.35 / $4,677.35 / $5,495.41