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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
$2,089.30 / $4,677.35 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $831.76 / $2,290.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $5,370.32 / $7,943.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,122.02 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $933.25 / $1,548.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $1,096.48 / $7,244.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $954.99 / $6,606.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $6,025.60 / $8,709.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $812.83 / $1,412.54