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Nebraska rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.96 / $9,185.68 / $20,928.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.14 / $602.96 / $3,038.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,522.85 / $8,579.33 / $16,595.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.74 / $914.90 / $1,225.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,091.67 / $2,091.67 / $2,091.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$923.88 / $1,333.13 / $1,896.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$586.66 / $969.27 / $3,850.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$828.13 / $1,404.63 / $4,073.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,205.96 / $1,500.75 / $2,389.42
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,064.03 / $1,423.58 / $1,793.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,037.06 / $4,800.83 / $7,772.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$828.13 / $1,369.59 / $1,783.66