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North Dakota 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 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $676.08 / $1,513.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,288.25 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,230.27 / $1,905.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $794.33 / $1,737.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,445.44 / $4,786.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $5,128.61 / $6,456.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,202.26 / $1,584.89