go back

New Jersey 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
$4,365.16 / $7,244.36 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $676.08 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $933.25 / $2,089.30
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $812.83 / $1,122.02
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $10,471.29 / $16,595.87
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $794.33 / $2,570.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $6,606.93 / $10,964.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $676.08 / $1,698.24