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Rhode Island rates for HCPCS 21422

Open Treatment Palatal/Maxillary Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,438.26 / $3,706.14 / $4,026.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.40 / $799.23 / $1,018.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.44 / $759.08 / $1,293.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$790.71 / $1,080.81 / $1,324.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,219.00 / $7,228.00 / $12,680.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.89 / $825.84 / $1,467.46