go back

South Carolina rates for HCPCS 21421

Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire fixation or fixation of denture or splint

Facilitymedian $4,571 · 10th–90th $692–$16,5960%5%10%10th90th$4,571Professionalmedian $708 · 10th–90th $513–$1,3490%10%10th90th$708$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $9,120.11 / $18,197.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $707.95 / $1,380.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $5,495.41 / $10,232.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $645.65 / $933.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $851.14 / $1,380.38
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,380.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $10,232.93 / $16,595.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $676.08 / $1,071.52