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Complex Open Repair of an Upper Jaw Fracture

Kentucky 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?

$4,030

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

Insurers have agreed to pay about $4,030 for this procedure. That total is two separate charges: $794 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$794$724 to $977
Facility feeThe hospital or surgery center$3,236$851 to $9,772

How much rates vary

Facilitymedian $3,236 · 10th to 90th $759 to $10,715Professionalmedian $794 · 10th to 90th $661 to $1,413
$1K$2K$5K$10Kfacility $3,236professional $794

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
$758.58
Median
$851.14
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$758.58
Typical High
$1,621.81
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$8,912.51
Median
$10,715.19
Typical High
$11,220.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$794.33
Typical High
$1,071.52
CareSource
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,000.00
Typical High
$1,288.25
CareSource
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$954.99
Typical High
$1,174.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$1,258.93
Typical High
$1,258.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,230.27
Typical High
$6,760.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$602.56
United
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$6,025.60
Typical High
$10,471.29
United
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$933.25
Typical High
$1,479.11

Where Kentucky 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

Kentucky· 36th of 50

$4,030

$794 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.