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Ohio rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.24 / $4,886.00 / $11,581.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$515.96 / $607.24 / $1,260.45
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,152.00 / $3,025.00 / $8,800.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.41 / $709.72 / $1,217.84
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$474.93 / $518.10 / $754.42
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.16 / $655.66 / $834.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.87 / $805.31 / $1,197.22
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$910.23 / $910.23 / $910.23
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$558.73 / $819.27 / $1,192.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.32 / $420.26 / $760.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,233.00 / $4,321.00 / $6,522.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.47 / $830.21 / $1,407.58