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New Jersey 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
$679.68 / $6,438.00 / $11,332.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.28 / $656.51 / $1,103.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$627.23 / $960.31 / $2,016.69
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$565.08 / $995.12 / $1,001.27
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,989.59 / $14,382.16 / $29,209.37
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.37 / $764.12 / $1,628.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,682.00 / $9,969.00 / $19,696.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.85 / $760.94 / $1,916.90