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New York rates for HCPCS 21422

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

Facilitymedian $5,623 · 10th–90th $1,230$12,3030%10%10th90th$5,623Professionalmedian $741 · 10th–90th $575$1,8200%20%10th90th$741$50.0$200.0$1.0K$5.0K$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
$954.99 / $4,897.79 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $741.31 / $1,659.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $7,762.47 / $13,803.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $691.83 / $1,659.59
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $37,153.52
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $1,071.52 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,047.13 / $2,884.03
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $870.96 / $2,290.87
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $954.99 / $1,348.96
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $831.76 / $1,318.26
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $851.14 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $5,495.41 / $12,589.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $870.96 / $2,691.53
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $741.31 / $3,090.30
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $794.33 / $1,949.84