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Arizona rates for HCPCS 21423

Open treatment of palatal or maxillary fracture (LeFort I type); complicated (comminuted or involving cranial nerve foramina), multiple approaches

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $4,474.00 / $7,960.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.06 / $764.80 / $1,257.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,640.00 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$827.09 / $945.25 / $1,181.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$679.49 / $929.83 / $1,564.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$760.46 / $1,033.07 / $7,140.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$683.23 / $859.55 / $6,581.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,637.00 / $6,477.00 / $9,010.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$677.65 / $800.94 / $1,542.79