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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
$891.25 / $2,691.53 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $724.44 / $1,202.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $6,760.83 / $11,481.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $831.76 / $1,000.00
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $870.96 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $5,248.07 / $11,748.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $724.44 / $1,148.15