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Washington, DC 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
$660.69 / $5,495.41 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $660.69 / $1,905.46
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $3,548.13 / $7,943.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $977.24 / $1,737.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,348.96 / $1,445.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $16,218.10 / $33,884.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $870.96 / $1,737.80