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Hawaii rates for HCPCS 21422

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

Facilitymedian $6,026 · 10th–90th $2,570–$6,0260%50%10th$6,026Professionalmedian $724 · 10th–90th $603–$1,1220%20%10th90th$724$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$2,570.40 / $6,025.60 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $676.08 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $812.83 / $977.24
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $954.99 / $1,122.02
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $724.44 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $794.33 / $977.24
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $776.25 / $870.96