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Connecticut rates for HCPCS 21422

Open Treatment Palatal/Maxillary Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,943.00 / $7,629.00 / $13,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$576.37 / $691.34 / $1,662.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,920.00 / $13,227.00 / $15,915.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.00 / $1,245.73 / $1,738.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$843.00 / $843.00 / $843.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$842.56 / $1,128.04 / $1,645.90
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,302.00 / $4,390.00 / $4,645.51
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$545.47 / $964.23 / $1,207.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,644.00 / $8,468.00 / $13,943.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.08 / $1,035.08 / $1,830.29