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Complex Open Repair of an Upper Jaw Fracture

Idaho 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?

$4,393

Typical total for the visit. In Idaho, July 2026.

Insurers have agreed to pay about $4,393 for this procedure. That total is two separate charges: $1,230 to the doctor who performs it, and $3,162 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,230$851 to $1,514
Facility feeThe hospital or surgery center$3,162$1,259 to $6,310

How much rates vary

Facilitymedian $3,162 · 10th to 90th $794 to $8,913Professionalmedian $1,230 · 10th to 90th $759 to $1,622
$1K$2K$5K$10K$20Kfacility $3,162professional $1,230

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
$3,388.44
Median
$4,466.84
Typical High
$8,709.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,047.13
Typical High
$1,621.81
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,818.38
Median
$4,073.80
Typical High
$9,772.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$1,513.56
Typical High
$1,584.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,023.29
Typical High
$1,412.54
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,174.90
Typical High
$1,995.26
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,380.38
Typical High
$1,819.70
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$6,165.95
Median
$7,585.78
Typical High
$10,232.93
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,548.82
Typical High
$1,698.24
Select Health
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$1,698.24
Select Health
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$1,202.26
Typical High
$5,495.41
United
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$12,022.64
Typical High
$27,542.29
United
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,148.15
Typical High
$1,621.81

Where Idaho sits

The same service costs 9.9 times more in Indiana than in West Virginia. 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.

Physician feeFacility fee

Idaho· 32nd of 50

$4,393

$1,230 physician + $3,162 facility

IN $15,967WV $1,608

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.