go back

Georgia 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
$1,412.54 / $5,370.32 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $707.95 / $1,412.54
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $645.65 / $645.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $3,467.37 / $6,918.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,047.13 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $1,071.52 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,023.29 / $1,621.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $954.99 / $3,548.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $6,456.54 / $12,022.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $870.96 / $1,412.54