go back

Virginia 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
$691.83 / $4,677.35 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $676.08 / $1,348.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,090.30 / $3,981.07 / $4,466.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $776.25 / $1,348.96
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $851.14 / $6,918.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $776.25 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $794.33 / $1,380.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $831.76 / $977.24
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $912.01 / $1,548.82
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $831.76 / $1,318.26
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $676.08 / $676.08
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $758.58 / $6,918.31
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $891.25 / $6,918.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $7,079.46 / $14,125.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $741.31 / $1,258.93