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Illinois 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
$1,023.29 / $3,548.13 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $870.96 / $1,949.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,244.36 / $8,709.64 / $17,782.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,318.26 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,122.02 / $1,659.59
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,348.96 / $3,981.07
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,000.00 / $1,122.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $5,370.32 / $12,302.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $954.99 / $1,584.89