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Complex Open Repair of an Upper Jaw Fracture

Illinois 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?

$4,283

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

Insurers have agreed to pay about $4,283 for this procedure. That total is two separate charges: $1,047 to the doctor who performs it, and $3,236 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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,047$794 to $1,479
Facility feeThe hospital or surgery center$3,236$1,479 to $5,623

How much rates vary

Facilitymedian $3,236 · 10th to 90th $1,023 to $10,000Professionalmedian $1,047 · 10th to 90th $724 to $2,138
$200$500$1K$2K$5K$10K$20Kfacility $3,236professional $1,047

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
$812.83
Median
$2,454.71
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$831.76
Typical High
$1,905.46
BCBS
Setting
Facility
Modifier
Global
Typical Low
$7,244.36
Median
$8,709.64
Typical High
$17,782.79
BCBS
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,230.27
Typical High
$1,479.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,122.02
Typical High
$1,659.59
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,348.96
Typical High
$3,981.07
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,000.00
Typical High
$1,122.02
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$85.11
Typical High
$1,023.29
United
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$5,011.87
Typical High
$12,302.69
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$977.24
Typical High
$1,621.81

Where Illinois 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

Illinois· 33rd of 50

$4,283

$1,047 physician + $3,236 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.