go back

Wyoming rates for HCPCS 21422

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$634.52 / $637.34 / $828.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,006.39 / $5,006.39 / $5,006.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,197.00 / $1,436.00 / $2,173.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$882.09 / $1,269.05 / $1,744.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,188.00 / $5,188.00 / $18,767.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$764.55 / $1,285.08 / $2,251.60