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Utah rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$888.61 / $3,294.00 / $7,679.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.40 / $888.61 / $3,038.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.61 / $885.10 / $1,307.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.16 / $371.42 / $613.80
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,525.68 / $6,104.56 / $8,896.10
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.47 / $1,002.25 / $1,929.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,981.00 / $3,613.00 / $7,048.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.27 / $777.29 / $1,156.72