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West Virginia rates for HCPCS 21422

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

Facilitymedian $794 · 10th–90th $603–$2,5700%20%40%10th90th$794Professionalmedian $661 · 10th–90th $562–$1,3490%20%40%10th90th$661$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
$602.56 / $602.56 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $630.96 / $1,348.96
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $794.33
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $1,071.52 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $933.25 / $5,754.40
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30,902.95 / $30,902.95 / $30,902.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $16,595.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $758.58 / $1,071.52