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North Dakota 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
$630.96 / $645.65 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $630.96 / $1,348.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,380.38 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,202.26 / $1,995.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $933.25 / $1,949.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,174.90 / $5,623.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,943.28 / $8,912.51 / $11,481.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,148.15 / $1,548.82