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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
$3,422.00 / $4,500.00 / $8,622.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.27 / $1,041.70 / $1,630.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$894.63 / $1,196.86 / $1,416.49
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.19 / $1,439.64 / $1,973.38
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,285.19 / $1,402.02 / $1,863.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $1,101.90 / $1,386.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,072.74 / $7,629.08 / $12,587.97
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,356.83 / $1,596.27 / $1,863.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $10,120.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$837.51 / $1,190.16 / $1,647.95