go back

Arizona rates for HCPCS 21422

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

Facilitymedian $4,786 · 10th–90th $1,738–$8,7100%5%10%10th90th$4,786Professionalmedian $708 · 10th–90th $575–$1,6220%10%20%10th90th$708$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $4,677.35 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $691.83 / $1,621.81
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $7,413.10 / $13,489.63
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $870.96 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $758.58 / $1,288.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $912.01 / $7,079.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $776.25 / $5,623.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $5,011.87 / $8,317.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $676.08 / $1,174.90