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Iowa rates for HCPCS 21422

Open Treatment Palatal/Maxillary Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,693.00 / $5,549.00 / $7,943.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.40 / $1,001.83 / $1,018.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,231.00 / $1,471.13 / $1,803.62
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.73 / $998.50 / $2,629.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,001.83 / $1,542.82 / $11,869.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$678.00 / $1,298.58 / $5,563.75
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,158.60 / $1,507.91 / $1,928.70
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,030.08 / $1,395.18 / $1,928.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,221.00 / $8,060.00 / $11,869.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$644.21 / $1,147.30 / $1,997.22
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$971.86 / $1,230.20 / $1,447.30