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Texas rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$714.00 / $3,511.00 / $12,040.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$522.02 / $647.32 / $1,014.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,278.78 / $4,217.06 / $8,686.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.06 / $637.88 / $1,023.87
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $498.97 / $498.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$910.23 / $910.23 / $910.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.21 / $834.79 / $1,349.06
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,791.10 / $11,500.00 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,008.16 / $4,721.60 / $5,455.58
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$556.83 / $736.63 / $1,241.80
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.77 / $884.37 / $1,138.85
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$603.90 / $603.90 / $603.90
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$556.83 / $746.49 / $1,265.76
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.72 / $886.50 / $1,393.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,154.00 / $3,451.00 / $7,600.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.47 / $761.02 / $1,171.33
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$539.99 / $608.40 / $857.82