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Complex Open Repair of an Upper Jaw Fracture

Washington, DC rates for HCPCS 21423

A surgery performed through an open incision to repair a fracture across the upper jaw, at the level where it separates the tooth-bearing bone from the rest of the face, in a case that is more complicated than usual, such as a fracture with many bone fragments or one that involves nerve pathways through the bone. The surgeon directly accesses and realigns the broken bone. It is used for a more complex version of this specific level of midface fracture rather than a straightforward break.

Rates data updated July 2026.

How much does Complex Open Repair of an Upper Jaw Fracture cost?

$1,175

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $1,175 for this service. Most negotiated rates run $832 to $4,074.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $5,129 · 10th to 90th $832 to $7,762Professionalmedian $832 · 10th to 90th $794 to $1,698
$1K$2K$5K$10K$20Kfacility $5,129professional $832

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$5,128.61
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$831.76
Typical High
$1,174.90
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$2,884.03
Typical High
$7,079.46
Cigna
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,071.52
Typical High
$2,238.72
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,584.89
Typical High
$1,819.70
United
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$13,182.57
Typical High
$34,673.69
United
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,122.02
Typical High
$2,187.76

Where Washington, DC sits

The same service costs 7.8 times more in California than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington, DC· 26th of 51

$1,175

CA $6,166KY $794

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.