go back

Indiana 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
$1,148.15 / $4,897.79 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $812.83 / $1,778.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $19,952.62 / $27,542.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $954.99 / $1,548.82
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $794.33 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $977.24 / $1,698.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $9,549.93 / $16,218.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $870.96 / $1,479.11