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Alabama rates for HCPCS 21422

Open treatment of palatal or maxillary fracture (LeFort I type);

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,659.59 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $691.83 / $1,318.26
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $741.31 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $6,456.54 / $8,709.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $851.14 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $758.58 / $1,479.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $4,365.16 / $6,918.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $645.65 / $1,148.15