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Rhode Island 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
$3,467.37 / $3,715.35 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $645.65 / $1,778.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $645.65 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $977.24 / $1,348.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $7,413.10 / $13,182.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $812.83 / $1,412.54