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Oklahoma 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
$1,288.25 / $3,890.45 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $660.69 / $1,318.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $9,772.37 / $15,848.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $831.76 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $851.14 / $1,096.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $1,862.09 / $8,128.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $724.44 / $5,623.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $5,754.40 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $660.69 / $912.01