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Washington, DC rates for HCPCS 21422

Open Treatment Palatal/Maxillary Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,017.00 / $4,100.00 / $7,007.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.46 / $656.46 / $656.46
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.34 / $731.77 / $5,899.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.79 / $1,010.47 / $1,734.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.04 / $1,430.57 / $1,430.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,261.00 / $4,165.00 / $26,408.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.71 / $880.29 / $1,732.04