go back

West 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
$512.86 / $602.56 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $602.56 / $954.99
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $562.34 / $676.08
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $602.56 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $912.01 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $812.83 / $3,019.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $9,332.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $676.08 / $1,000.00