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Arkansas rates for HCPCS 21422

Open Treatment Palatal/Maxillary Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$804.79 / $1,477.00 / $3,000.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$567.60 / $800.36 / $941.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.37 / $830.47 / $879.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$709.38 / $1,003.52 / $1,161.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,565.00 / $2,828.00 / $6,957.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.27 / $843.65 / $1,206.88