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Texas rates for HCPCS 21422

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

Facilitymedian $2,951 · 10th–90th $794–$12,0230%5%10th90th$2,951Professionalmedian $724 · 10th–90th $562–$1,2300%10%20%10th90th$724$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
$1,000.00 / $3,715.35 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $691.83 / $1,148.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,148.15 / $5,754.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $741.31 / $977.24
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $575.44 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,412.54
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $21,877.62
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $5,754.40
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $977.24 / $4,677.35
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $831.76 / $1,348.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $81.28 / $537.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,445.44
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,348.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $6,025.60 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $691.83 / $1,096.48
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $588.84 / $602.56