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Louisiana 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
$785.57 / $2,447.00 / $5,150.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$596.11 / $817.48 / $1,171.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,844.54 / $6,756.83 / $11,511.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.75 / $806.51 / $1,204.98
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $575.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.00 / $400.00 / $400.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.71 / $876.02 / $1,184.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,141.00 / $4,717.00 / $11,696.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$565.97 / $732.44 / $1,314.02