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Tennessee rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$853.00 / $2,678.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.56 / $667.87 / $1,036.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,201.00 / $3,880.00 / $5,878.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.29 / $928.09 / $1,454.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.57 / $857.80 / $1,387.36
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,791.10 / $3,850.56 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,008.16 / $4,721.60 / $5,455.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,794.00 / $3,626.00 / $6,291.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.90 / $796.27 / $1,466.81