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Surgical Repair of a Broken Upper Jaw

Missouri rates for HCPCS 21422

Surgery to repair a break running across the upper jaw that separates the tooth-bearing part of the face from the bone above it. The surgeon exposes the fracture, moves the jaw back to its correct position against the rest of the face, and secures it so the teeth meet properly while healing. Restoring the bite is the main aim.

Rates data updated July 2026.

How much does Surgical Repair of a Broken Upper Jaw cost?

$5,042

Typical total for the visit. In Missouri, July 2026.

Insurers have agreed to pay about $5,042 for this procedure. That total is two separate charges: $776 to the doctor who performs it, and $4,266 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$776$661 to $1,023
Facility feeThe hospital or surgery center$4,266$2,692 to $5,623

How much rates vary

Facilitymedian $4,266 · 10th to 90th $1,479 to $8,318Professionalmedian $776 · 10th to 90th $575 to $3,467
$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0Kfacility $4,266professional $776

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,698.24
Median
$4,265.80
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$758.58
Typical High
$3,890.45
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$4,570.88
Typical High
$8,317.64
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$794.33
Typical High
$1,258.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$707.95
Typical High
$977.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$851.14
Typical High
$1,380.38
Medica
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$1,071.52
Typical High
$4,466.84
Medica
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$912.01
Typical High
$5,623.41
United
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$3,981.07
Typical High
$6,606.93
United
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$776.25
Typical High
$1,230.27

Where Missouri sits

The same service costs 12.2 times more in Indiana than in West Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility feeMissouri $5,042 · 31st of 50
IN $16,149WV $1,327

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.