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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
$1,392.00 / $4,856.00 / $14,100.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$523.69 / $656.28 / $656.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,585.95 / $10,462.75 / $16,531.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.54 / $824.96 / $1,047.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $900.00 / $900.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$672.91 / $843.92 / $1,066.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$656.28 / $1,001.60 / $7,964.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$565.97 / $732.44 / $5,563.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,481.00 / $5,910.00 / $9,232.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.67 / $694.02 / $938.85