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Kansas 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
$3,000.00 / $6,560.00 / $13,151.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$576.37 / $635.55 / $1,004.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$622.00 / $622.00 / $622.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.81 / $1,059.78 / $1,059.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$624.00 / $624.00 / $624.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$672.56 / $872.21 / $1,330.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$635.55 / $1,004.20 / $5,032.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.16 / $825.88 / $5,563.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,967.00 / $4,960.00 / $11,732.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$666.06 / $779.66 / $1,174.01