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North Carolina rates for HCPCS 21422

Open treatment of palatal or maxillary fracture (LeFort I type);

Facilitymedian $2,344 · 10th–90th $676–$12,5890%10%10th90th$2,344Professionalmedian $832 · 10th–90th $589–$1,7780%10%10th90th$832$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $4,786.30 / $12,589.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $691.83 / $1,584.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $6,309.57 / $8,912.51
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $870.96 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $912.01 / $1,445.44
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,479.11
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $870.96 / $1,380.38
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,122.02 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $11,748.98 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $741.31 / $1,348.96
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $21,877.62 / $21,877.62
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,754.40 / $5,754.40