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Massachusetts rates for HCPCS 21422

Open Treatment Palatal/Maxillary Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,528.00 / $2,894.00 / $6,107.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$596.11 / $679.13 / $1,018.99
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,423.43 / $3,895.00 / $12,850.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$665.85 / $1,146.25 / $5,747.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.68 / $1,114.15 / $1,844.76
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$634.67 / $1,372.24 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.30 / $882.21 / $1,207.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$785.20 / $1,485.68 / $1,955.62
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $4,362.54 / $12,850.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$704.80 / $1,214.45 / $5,747.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,324.00 / $5,097.00 / $10,764.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$679.88 / $1,030.44 / $1,843.22