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Idaho 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
$3,388.44 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,047.13 / $1,621.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $4,073.80 / $9,549.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,513.56 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,071.52 / $1,380.38
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $1,318.26 / $2,089.30
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,348.96 / $1,819.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $7,585.78 / $10,232.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,548.82 / $1,698.24
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $707.95 / $1,659.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $10,232.93 / $27,542.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,148.15 / $1,621.81