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New Mexico 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
$912.01 / $2,089.30 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $630.96 / $1,412.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,803.84 / $30,902.95 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $912.01 / $2,137.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $933.25 / $1,412.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $977.24 / $1,445.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $11,220.18 / $25,703.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $912.01 / $1,258.93