go back

Rhode Island 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
$3,019.95 / $3,715.35 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $676.08 / $1,778.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $660.69 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $870.96 / $1,412.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $4,677.35 / $7,585.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $794.33 / $1,412.54